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What Are the Causes and Effects of HIE During Childbirth?

Written by Berkowitz

newborn baby

Hypoxic-ischemic encephalopathy (HIE) is a potentially-serious birth injury that can result from a variety of different causes. While some of these causes are natural, most can be avoided with proper medical care, and a significant number of cases of HIE result directly from mistakes during pregnancy, labor, and delivery. As a result, for new parents whose children have been diagnosed with HIE, determining whether you have a medical malpractice claim is an important part of the coping and recovery processes.

In this article, we will provide an overview of the key points you need to know.

Answers to 10 Important Questions about Hypoxic-Ischemic Encephalopathy (HIE)

If your child is diagnosed with HIE as the result of medical malpractice, understanding the legal implications can be difficult, but it is extremely important. The financial and non-financial impacts can be substantial, and filing a successful medical malpractice claim may be your option for recovering your family’s losses. So, what do you need to know to get started? Here are answers to 10 important questions from our highly-experienced birth injury lawyers:

1. What Is Hypoxic-Ischemic Encephalopathy (HIE)?

Hypoxic-ischemic encephalopathy is a type of brain injury that results from the brain being deprived of the oxygen it needs in order to develop as it is supposed to. During gestation and childbirth, the fetus needs a steady supply of oxygen, and this supply comes from the blood. If a fetus is deprived of oxygen-rich blood for any significant length of time, this can have severe detrimental effects – with the severity of these effects being determined by the amount of oxygen the fetus’s brain is able to receive, among other factors.

While hypoxic-ischemic encephalopathy is the primary medical term for inadequate supply of oxygen-rich blood to a fetus’s brain, this condition may also be referred to as birth asphyxia, neonatal encephalopathy, or perinatal asphyxia, although these terms may be more or less accurate, depending on the specific nature of the birth injury in question.

2. Are There Risk Factors for HIE?

Yes, there are a number of risk factors that can potentially increase the chances of a fetus’s brain developing abnormally due to HIE. However, as we will get to later, even if you or your child’s mother has been diagnosed with one of the conditions below, or even if one of the adverse events discussed below occurred during your pregnancy, it is still very possible that your child’s HIE is ultimately attributable to medical negligence. With this in mind, potential risk factors for HIE include (but are not limited to):

  • Being pregnant with multiples
  • Breech presentation, macrosomia, and other fetal abnormalities
  • Getting pregnant after age 35
  • Infections during pregnancy (maternal or fetal)
  • Maternal diabetes (including gestational diabetes)
  • Maternal drug or alcohol use
  • Maternal high blood pressure
  • Maternal obesity
  • Placental complications (such as placental abruption or placenta previa)
  • Significantly premature birth or post-term pregnancy (being pregnant for more than 42 weeks)
  • Umbilical cord complications (such as compression, infection, or prolapse)

3. What Types of Medical Mistakes Can Cause a Child to Be Born with HIE?

This non-exclusive list of risk factors sheds light on some of the types of medical mistakes that can cause a child to be born with HIE. In particular, failure to diagnose maternal and fetal health conditions is among the leading causes of HIE during childbirth, and it is also among the easiest causes to avoid. With appropriate testing, treatment, and patient counseling, doctors should be able to identify essentially all of the risk factors listed above. With this information, they should be able to provide appropriate treatment and/or provide expecting mothers with the medical advice they need in order to make informed decisions about their care and the delivery process.

Other medical mistakes that can result in a child being born with HIE include (but are not limited to):

  • Failure to treat diagnosed material or fetal health conditions
  • Failure to adequately monitor the fetus’s blood-oxygen supply
  • Mismanagement of high-risk pregnancies
  • Improper use of forceps or vacuum extractors
  • Failure to recommend a cesarean birth or perform an emergency C-section
  • Failure to utilize therapeutic hypothermia

4. What Are the Symptoms of HIE?

Hypoxic-ischemic encephalopathy has several possible symptoms. Critically, many of these symptoms, even when grouped together, can be indicative of other health conditions as well (particularly shortly after childbirth). So it is imperative that parents who have concerns seek advice from a physician who specializes in treating newborns with neonatal brain injuries. The most common symptoms of HIE include:

  • Abnormal body movements or seizures
  • Abnormal muscle tone (with limbs being unusually floppy or tense)
  • Blood abnormalities
  • Difficulty breathing
  • Difficulty feeding
  • Having a weak cry
  • Heart, kidney, liver, or lung dysfunction
  • Low heart rate
  • Not being alert
  • Not responding to loud sounds or noises

In addition, a low APGAR score can be symptomatic of HIE. Once again, however, a low APGAR score can have several different causes (and its implications can range from highly significant to non-existent). As a result, before making any decisions about your child’s care, it is absolutely essential that you obtain an accurate diagnosis of his or her condition. Typically, diagnosis of HIE involves the use of an electroencephalogram and magnetic resonance imaging (MRI), though various other testing methodologies may also be used.

5. What Are the Possible Prognoses for a Child Diagnosed with HIE at Birth?

The prognoses for children diagnosed with HIE during childbirth vary significantly. Some children will fully recover (with therapeutic hypothermia significantly increasing the chances of full recovery in many cases), and some will experience lifelong disabilities. Ultimately, a child’s chances of fully recovering depend not only on the timing and extent of the damage caused, but on the attending physician’s efforts to diagnose and treat the child’s condition after childbirth as well.

Some of the most significant potential long-term effects of HIE during childbirth include:

  • Behavioral and emotional disorders
  • Cerebral palsy
  • Developmental delays and disabilities
  • Epilepsy and other seizure disorders
  • Hearing and vision impairments
  • Learning and speech disabilities
  • Respiratory complications

This list is not exhaustive; and, of course, each of the conditions listed above comes with its own unique set of risks, complications, and consequences. If your child is diagnosed with HIE, it will be important for your family to gain a clear understanding of its effects, and these effects may not become fully apparent until months or years after birth.

6. What Are the Medical Treatment Needs of a Child Born with HIE?

Just as the long-term effects of an HIE diagnosis can vary greatly, so can the medical treatment needs of children born with HIE. In virtually all cases, however, the costs of necessary medical care will be substantial. Diagnostic testing alone can cost more than most families can afford to pay. And for families whose children will experience lifelong effects, the costs can be truly astonishing. For example, the Centers for Disease Control and Prevention (CDC) have estimated the lifetime cost of treatment for cerebral palsy at almost $1 million.

7. When Can Families Seek Financial Compensation for an HIE Diagnosis?

Given the inordinate costs of medical care, and given that many cases of hypoxic-ischemic encephalopathy are the result of medical negligence, parents whose children have been diagnosed with HIE are right to be thinking about filing claims for financial compensation. If your child’s medical condition is the result of medical malpractice, then your family is entitled to a significant financial recovery under Connecticut law.

Depending on the circumstances involved, your hospital, your physician (or his or her medical malpractice insurance company), and various other parties could all potentially be liable for the financial and non-financial costs of your child’s diagnosis. In order to determine your family’s legal rights, it will be important for you to sit down with a Connecticut medical malpractice lawyer who has specific experience handling serious birth injury claims.

8. What Are Your Next Steps If Your Child Is Exhibiting Symptoms of HIE?

If your child is exhibiting symptoms of HIE, your next step is unquestionably to seek a diagnosis right away. You should go to a different doctor than the one who delivered your child. And if you are not sure where to go, we would be more than happy to provide you with a referral at no cost or obligation.

9. What Are Your Next Steps If Your Child Is Diagnosed with HIE?

If your child has already been diagnosed with HIE, then in general terms, your next steps are to: (i) follow your new doctor’s treatment plan, (ii) figure out a financial plan, and (iii) speak with a medical malpractice attorney. Your family has a long road ahead. The more you can do to get ahead in terms of aggressively treating your child’s condition and ensuring that your family has the necessary financial resources, the better off you and your child will be.

10. How Can a Medical Malpractice Lawyer Help You?

How can a medical malpractice attorney help? In perhaps the most direct way, an attorney can help by seeking financial compensation on your family’s behalf. Your attorney will be able to determine who is liable, gather the evidence needed in order to prove liability, and then take the steps necessary to secure the compensation your family deserves. However, there are many other ways that an experienced medical malpractice attorney can help as well. For example, at Berkowitz Hanna, we work closely with our clients in many different respects, from helping them choose specialists to helping them understand the financial and non-financial impacts of their children’s diagnoses.

Schedule a Free Initial Consultation with the Birth Injury Lawyers at Berkowitz Hanna

If you live in Connecticut and would like more information about filing a medical malpractice claim as the result of your child’s HIE diagnosis, we encourage you to get in touch. To schedule a free, no-obligation consultation with our highly-experienced birth injury lawyers, please call us directly or request an appointment online today.