Hypoxic Ischemic Encephalopathy (HIE) and Birth Asphyxia
Hypoxic Ischemic Encephalopathy (HIE), more commonly called birth asphyxia, is a type of birth injury when there is a lack of oxygen and blood flow to the baby’s brain at or close to the time of the baby’s birth. HIE occurs in approximately 2-9 out of 1,000 live births. Out of those who are affected, 10-60% die when they are a newborn and around 25% who live will suffer from severe brain damage and long-term neurodevelopmental impairments.
What Can Cause HIE/ Birth Asphyxia?
HIE can be caused by many different situations that can occur during labor and delivery, including:
- Complicated from the baby’s position or size
- Delayed delivery
- Delayed emergency C-section
- Elevated fetal heart resting tone between contractions
- Fetal monitoring errors
- Problems with the placenta or uterus
- Tachysistole (excessively frequent uterine contractions)
- Trauma to or hemorrhages during delivery in the baby’s brain
- Umbilical cord injuries
- Undiagnosed or improperly treated conditions in the mother
When babies are inside of the mother’s uterus, they are dependent on their mother for exchanging oxygen and carbon dioxide. Although a fetus does develop lungs while in the womb, they do not use their lungs for breathing the same way that they do once they are born. Fetus “breathing” happens in the intervillous space inside of the placenta, which is where the maternal blood travels. The blood that gets oxygenated from the mother is diffused into capillaries inside of the placenta. The umbilical vein inside of the umbilical cord then is able to get this oxygenated blood and brings it to the baby’s heart, which will then pump the blood to the baby’s body. Once the blood has been used by the baby, it is taken away from the heart and brought back to the placenta.
The umbilical artery blood may be examined to figure out if a baby suffered oxygen deprivation, which is called an anoxic or hypoxic/ischemic event. If it is found that the umbilical artery blood is academic, that will usually mean that anaerobic metabolism has happened, which is metabolism that happens if oxygen was unavailable. This is typically an indicator that an anoxic event has taken place. Anoxic/hypoxic ischemic events are known to cause hypoxic ischemic encephalopathy (HIE), which is when permanent brain damage occurs and this can lead to seizure disorders or cerebral palsy.
Artery Cord Blood Sample and Acidosis in the Fetus or Newborn
In the majority of newborns who are severely asphyxiated, when they are born, perfusion is poor to nonexistent. This also includes poor umbilical circulation. The umbilical arteries only reflect the fetal tissue status until the flow in them has ceased. Any lactic acid that came from hypoxia/anoxia at the tissue level will not be cleared to go to central circulation, which includes the umbilical arteries. Therefore, if a fetus or newborn is asphyxiated, their cord gas sample could severely underestimate the acidosis. Once the baby is resuscitated, their circulation gets better and the tissue lactic acid is cleared into the central circulation. Since the lactic acid entered the central circulation, the postnatal base deficit that was received from the asphyxiated newborn during the first hour after they were born is often found to be higher than in the umbilical cord blood gas. Blood gas is an extremely accurate predictor of neurological outcomes.
How are Umbilical Cord Gases Used in Litigation?
There are many different times in which umbilical cord blood cases can be used in litigation. Hospitals may try to use normal umbilical cord gas results in order to defend themselves in a case. However, there are numerous reasons why a baby who suffered asphyxia/hypoxia could have received a normal cord gas:
- The baby may have had poor circulation and perfusion right after they were born
- The baby may have received invalid results due to an error in how the cord gas was drawn, stored or analyzed
- The baby may have suffered a head injury while being delivered that caused ischemia in their brain
In addition, there are many different technical errors that can also have an effect on the umbilical cord gas results. In fact, around 18-20% of cord gas results are not valid because of a technical error.
Free Consultation with a Chicago Birth Injury Attorney
RB Law has vast experience with handling birth injury cases. Umbilical cord gas results can play a very important role in litigation and it is imperative that you obtain the legal services of an attorney with experience in this area. If you have questions regarding your birth injury case, contact us today for a free consultation at (312) 458-1000, 24 hours a day, 7 days a week.