What Causes Infant HIE, and What Can I Do About It?

Hypoxic Ischemic Encephalopathy (HIE) is a neonatal birth injury caused by a lack of oxygen and blood flow to the baby's brain. It can occur at or near birth and, if the baby survives, often results in devastating neurological impairments. There are a number of complications and medical mistakes that can result in HIE, which may lead to brain dysfunction, permanent brain damage, or even death.

The majority of cases occur due to a failure to diagnose or a misdiagnosis. However, it is preventable in the vast majority of cases as long as the doctor responds quickly and competently. If you believe your baby suffered from HIE due to medical negligence, it is important that you contact the appropriate, qualified legal professionals right away.

What Causes Neonatal Hypoxic Ischemic Encephalopathy During Pregnancy?

During pregnancy, a baby is at a higher risk for neonatal encephalopathy if the pregnancy is considered ‘high-risk.’ In a high-risk pregnancy, the mother requires close monitoring to ensure proper medical intervention should she need it. If a doctor fails to diagnose a pregnancy as high-risk, both mother and baby could suffer. Some of the conditions that classify pregnancy as high-risk are:

• Diabetes
• Problems with blood circulation to the placenta
• Preeclampsia - high blood pressure during pregnancy
• Very low blood pressure
• Cardiac disease
• Congenital infections
• Drug and alcohol abuse
• Age
• Previous complications

What Causes HIE During Birth?

There are many complications that may arise during labor or delivery, and it is imperative that medical professionals act promptly to prevent HIE in these instances. The following are some of the most common complications that lead to HIE during labor and delivery.

• Placenta Previa: Occurs when the placenta attaches to the uterus too close to the cervix. This can cause heavy bleeding during delivery and is a threat to both mother and baby. The condition is detectable during the second half of pregnancy if the mother experiences intermittent bleeding. To reduce the risk of hypoxic ischaemic encephalopathy, the baby will typically be delivered through C-section.
• Umbilical cord accidents: As the baby’s sole source of oxygen and nutrients, the umbilical cord plays a vital role in keeping the baby healthy. If, at any point during birth, the umbilical cord is compromised and cerebral blood flow is constricted, the baby can quickly develop HIE. There are several ways in which this can happen during birth.
  • True Knot: A knot forms in the cord, restricting airflow
  • Nuchal Cord: The cord becomes wrapped around the baby’s neck
  • Vasa Previa: Blood vessels move into the birth canal, resulting in blood loss and oxygen deprivation
  • Umbilical Cord Prolapse: The umbilical cord leaves the uterus before the baby
• Prolonged labor: Labor length can vary greatly from mother to mother. In any case, medical professionals should look for certain indicators to ensure the birth is progressing normally. When labor is prolonged, there is an increased risk of fetal distress, which can lead to HIE. Medical interventions may be necessary to safely deliver the baby.
• Abnormal fetal position: If a baby is not delivered head-first, it is much more likely that it will experience HIE. If initial attempts to shift the baby are unsuccessful, a C-section is highly recommended.
• Uterine rupture: When a woman’s uterus tears during delivery, the baby can shift into the abdominal cavity. This is accompanied by massive bleeding and a resulting drop in the mother’s blood pressure, decreasing blood flow to the baby. In many instances, the placenta then becomes detached from the uterus, cutting off the baby’s supply of oxygen as well. When the uterus ruptures, an emergency C-section is required. Medical professionals have to act quickly to ensure the baby’s oxygen and blood flow are restored before there is any lasting neurological damage.

How Can HIE Affect My Baby After Birth?

Sometimes, complications do not arise until after birth. Without timely treatment, the impact of such complications can be deadly. However, with proper medical care, most of these are avoidable. Below are some of the ways HIE may develop after birth due to improper monitoring and care.

• Severe prematurity: Premature babies are at a higher risk for HIE because their brains are still in the process of developing. In addition, they are typically unable to breathe on their own as their lungs are underdeveloped.
• Hypoglycemia: Newborn brains rely on glucose for energy. It is important that their sugar levels never drop too low, as this can lead to brain bleeds and HIE. Low glucose levels are easily treated when diagnosed and treated promptly.
• Respiratory Distress: Babies who have a complicated birth can often experience respiratory distress due to birth asphyxia. In these cases, the babies have to be properly placed on a ventilator to ensure their breathing stays regulated and to prevent lung collapse. When the tube is not placed properly, or the pressure is not input accurately, the baby is at high risk for HIE, as well as brain bleeds.

What Are The Long-Term Effects Of HIE?

The impact of HIE varies based on the extent of the brain damage and may become more apparent as the child grows. HIE can lead to a range of neurological and developmental issues, such as:

• Mild HIE: Infants with mild hypoxic ischemic encephalopathy may have minimal or no long-term disabilities.
• Moderate to severe HIE: Infants with moderate to severe HIE may face long-term challenges, including:
  • Cerebral palsy
  • Intellectual disabilities
  • Feeding difficulties
  • Learning disabilities
  • Visual or hearing impairments
  • Seizures
  • Newborn death

Therapeutic hypothermia is a treatment in which the baby's body temperature is lowered to reduce the injury and long-term complications. This treatment can be used to treat moderate to severe HIE in newborns who are at least 35 weeks gestational age, weigh at least four pounds, and are within six hours from birth. The treatment involves active cooling for 72 hours, followed by rewarming for 12 hours.

What Can I Do if My Baby Has HIE?

An HIE diagnosis is often overwhelming, both emotionally and financially. The brain injury attorneys at Ross Feller Casey have an unmatched record of legal success representing families affected by hypoxic-ischemic encephalopathy. As such, you can trust that our experienced team has the extensive knowledge and resources to ensure your case gets the attention it deserves.

If your baby was diagnosed with HIE, and you think it may be the result of a medical mistake, contact our law offices today for your free consultation. It is time to get the financial compensation you and your family deserve.