Hypoxia Lawyer

PERINATAL BRAIN DAMAGE AND HETEROTOPIC OSSIFICATION

There is some proof of a significant link between heterotopic ossification and those who suffered traumatic brain injuries. This likely explains the increased risk of these bony growths in the joints of children with cerebral palsy.

While it is not as common as a coexisting condition like epilepsy or intellectual disability, heterotopic ossification is a relatively common issue faced by children with cerebral palsy. According to a study in Developmental Medicine & Child Neurology that examined the medical records of about 200 children with a cerebral palsy diagnosis, they found that more than 15% also had heterotopic ossification.

According to this study, 16% of the patients had both cerebral palsy and heterotopic ossification. The factors that appeared to increase the risk for heterotopic ossification include:

• Those who had a quadriplegic (all four limbs involved) type of cerebral palsy.
• Those who could not walk unassisted.
• Those who underwent a previous capsular release (a minimally-invasive shoulder surgery).
• Those who had previous infections, often following a procedure.
• Those who underwent previous hip operations.

In general, they found that the children most affected by cerebral palsy are also the most at-risk of heterotopic ossification. In fact, according to this study, children who have a quadriplegic type of cerebral palsy are 17.5 times more likely to have heterotopic ossification than a child with a hemiplegic type of cerebral palsy.

WHAT ARE THE EFFECTS OF FETAL HYPOXIA?

Fetal hypoxia can have devastating effects on a newborn, leaving them with disabilities and challenges they will face for the rest of their lives. The severity of these effects can vary widely. Many factors play a role in the type of complications and how severe they are. This includes how little oxygen made it to the brain and other vital organs, how long the baby experienced reduced oxygen, and what parts of the body were affected.

Possible Effects of Different Types of Fetal Hypoxia on Your Baby

Babies who experience any type of fetal hypoxia during early pregnancy or through the second trimester may not reach their full growth potential they would have without the complication. In fact, some babies with fetal hypoxia are diagnosed with intrauterine growth restriction. This condition can both cause and be a result of decreased oxygenation.

Other complications related to any type of fetal hypoxia include:

• Metabolic concerns
• Hematologic conditions
• Damage to vital organs
• Hypoxic-ischemic encephalopathy

According to Benioff Children’s Hospital, hypoxic-ischemic encephalopathy is a type of brain damage caused by hypoxia. It can lead to many lifelong problems for children. This may include:

• Intellectual disabilities and other cognitive dysfunction
• Behavioral concerns
• Cerebral palsy

All types of hypoxia, including both chronic hypoxia during development and acute hypoxia during delivery, can cause changes in the tissues of the heart that alter function. These children may be at an increased risk of cardiovascular issues later in life.

WHAT IS THE DURATION OF A FETAL HYPOXIA DIAGNOSIS?

A fetal hypoxia diagnosis can have effects that last a lifetime. Fetal hypoxia can take place during pregnancy, labor, or delivery. When a fetus does not get enough oxygen, the results can include cerebral palsy, retinopathy, chronic lung disease, hearing loss, cardiac problems, and death during the weeks before or after delivery.

WARNING SIGNS THAT A PREGNANT WOMAN MIGHT BE HYPOXIC

The obstetric team should take great care in monitoring pregnant women who have an increased risk of hypoxia due to the mother:

• Living at a high altitude and receiving less oxygen
• Having a pre-existing cardiovascular disease like pulmonary hypertension, heart failure, or cyanotic heart disease
• Having anemia
• Having a blood disorder, like sickle cell anemia
• Having an infection, like an acute respiratory infection
• Having chronic inflammation

These conditions can limit the mother’s oxygen intake and her ability to deliver sufficient oxygen to the fetus. It might be necessary to administer oxygen to the mother or take other measures to increase the delivery of oxygen to the fetus.

THERE ARE MANY CONDITIONS ASSOCIATED WITH FETAL HYPOXIA

When hypoxia is chronic and affects the fetus early, the baby may not reach full size. Intrauterine growth restriction can be both a cause and an effect of fetal hypoxia. According to a study published in the International Journal of Pediatrics, babies who go without full oxygen either before, during, or after delivery may also experience:

• Meconium aspiration
• Metabolic concerns
• Hematologic conditions
• Low birth weight
• Prematurity
• Increased risk of infant mortality

One of the most common issues associated with fetal hypoxia is hypoxic-ischemic encephalopathy. This type of brain damage can result in intellectual disabilities, developmental disabilities, behavioral concerns, and more, as well as seizures and cerebral palsy.

Chronic hypoxia during development can also cause damage to the heart, leading to an increased risk of heart disease and other cardiovascular conditions later in life.

DIAGNOSING AND TREATING FETAL HYPOXIA

When hypoxia occurs in the uterus, fetal oximetry and other testing are often used to diagnose the condition. Symptoms of intrauterine growth restriction may also play into a prenatal diagnosis. When hypoxia occurs just before, during, or immediately after delivery, symptoms after birth may lead to a diagnosis. According to Benioff Children’s Hospital, seizures are a common early sign of hypoxic brain injury.

Initial treatment may include medications to stop seizures and support breathing and other body processes. In some cases, lowering the baby’s body temperature and inducing hypothermia can help reduce the implications of fetal hypoxia. A better neurological outcome may be possible for selected infants who qualify for this treatment.

Many children who suffer complications related to fetal hypoxia will require lifelong monitoring, in addition to medication and therapy for related medical conditions.

PRE-ECLAMPSIA AND FETAL HYPOXIA

If the mother develops pre-eclampsia during the pregnancy, medical personnel must take immediate measures to save the mother’s life and to avoid harm to the fetus. If it is severe, the fetus could sustain significant harm from a lack of oxygen. If pre-eclampsia occurs before 33 weeks of gestation, there is a high likelihood of fetal mortality and morbidity. Both the mother and baby have a higher than average risk of developing premature cardiovascular disease in the future.

HOW FETAL HYPOXIA AFFECTS THE DEVELOPMENT OF A FETUS

In order to survive, a fetus that is not getting enough oxygen will shift its energy to life support functions, sacrificing the development of other organs and body systems. The blood supply to the brain, heart, and upper body will increase. As a result, the blood flow to the gastrointestinal tract, kidneys, and legs will decrease, adversely impacting the development of those areas.

If the insufficient oxygen worsens or continues, eventually the fetus will sustain damage to the heart and brain. At that point, the fetus can die if not delivered within a matter of days. Even if delivered in time to save its life, the baby can experience lifelong impairments from the damage the hypoxia caused. Also, these babies have a higher risk of developing hypertension later in life.

TREATING FETAL HYPOXIA

According to Mayo Clinic, the obstetrician should perform a biophysical profile to assess the health of the fetus. If the biophysical profile reveals abnormalities or the mother or pregnancy has risk factors for hypoxia or other complications, the doctor should continue to monitor the mother and fetus closely. Sometimes it is necessary to deliver the baby early or immediately.

A fetal biophysical profile consists of:

• A nonstress test to monitor the fetal heart rate and
• A fetal ultrasound to check the baby’s breathing, heart rate, amniotic fluid level, and muscle tone

FETAL HYPOXIA DURING LABOR AND DELIVERY

The baby can receive insufficient oxygen during labor or delivery because of several factors, which can include:

• The labor goes on for an unusually long time.
• The contractions are too strong or too close together.
• The baby is in a breech position or some other non-optimal presentation when going through the birth canal.
• The baby is too large for vaginal delivery.
• The mother is in medical distress.
• The pregnancy lasts well beyond the weeks of a typical pregnancy.

The medical personnel has several options for dealing with these situations, depending on the details of the individual case. Failure to monitor or respond promptly to problems during labor and delivery can cause permanent harm to the baby from a lack of oxygen.

WHAT TO DO ABOUT FETAL HYPOXIA

Fetal hypoxia can impact a person’s development, cognitive abilities, and life path. Damage to the brain, heart, lungs, kidneys, and gastrointestinal tract can be permanent and debilitating.

Your right to recover damages will depend on your state’s laws about birth injuries. Some states have programs with strict rules that govern these situations. These programs often have short deadlines for taking action against the party whose carelessness caused or contributed to the harm your baby suffered. If you miss the deadline or any of the other requirements, you could lose the right to go after money damages.

Depending on your state and the facts of your case, you might be able to recover compensation for the medical expenses, ongoing therapies and interventions, life care, and disability. These cases are sophisticated litigation. You should work with someone who has experience navigating birth injury cases.

UNDERSTANDING THE EFFECTS OF FETAL HYPOXIA

The effects of fetal hypoxia vary depending on:

• When the baby was without adequate oxygen
• How long the baby was without adequate oxygen
• What organs or parts of the brain were affected by the lack of adequate oxygen
• A number of other factors

In general, some of the most common effects of fetal hypoxia include:

Damage Caused by Chronic Hypoxia During Development

According to a study published in the International Journal of Pediatrics, babies who do not get the oxygen they need during key stages of development may experience intrauterine growth restriction, which can result in low birth weight and other complications. In addition, they may face metabolic and hematologic concerns that require treatment or ongoing monitoring.

Damage to the Brain

Any type of fetal hypoxia can lead to brain damage known as hypoxic-ischemic encephalopathy. According to Benioff Children’s Hospital, this type of brain damage can cause developmental delays, intellectual disabilities, and other cognitive dysfunction; cerebral palsy; and seizure disorders.

Damage to the Heart and Other Organs

Both acute and chronic hypoxia can lead to problems with the cardiovascular system later in life, including an increased risk of heart disease. This is because hypoxia leads to both morphological and functional changes in the heart. Other organs, such as the kidneys or the bowel, may also suffer damage because of hypoxia.

TREATMENTS AND OUTCOMES IN CHILDREN WHO SUFFERED FETAL HYPOXIA

The treatment for fetal hypoxia depends greatly on the size and gestational age of the infant. In some cases, doctors must deliver an infant early in order to help them get the proper oxygen levels. Premature infants and those who are extremely small may need extra support and care to survive.

Some full-term infants may benefit from hypothermia therapy, which requires lowering the body temperature to reduce the risk of neurological damage. This has been effective in improving the outcome for many survivors, including some who would likely pass away without this type of treatment.

Many children who experienced hypoxia during gestation or delivery have lasting impairments, although these vary in severity. Depending on their individual needs, they may require ongoing monitoring, therapy, anti-seizure medications, and drugs to reduce spasticity.

Many of the treatments and types of medical care necessary for babies who suffered fetal hypoxia are costly. You may be able to hold a doctor liable for the costs of your baby’s treatment.

TREATMENTS TO HELP MITIGATE AND OVERCOME THE EFFECTS OF FETAL HYPOXIA

Prompt medical care to ensure the baby gets the oxygen they need is the best way to reduce the risk of severe, lifelong organ or brain damage. However, for some infants, there is another promising treatment to reduce the risk of damage even after going without adequate oxygen. This requires doctors to lower the baby’s core body temperature.

While this type of hypothermia therapy is not always appropriate for all babies, and cannot be used on most premature infants (as supported by a study published in Early Human Development), it can improve the neurological outcome for some children. Doctors must begin this treatment quickly after birth for it to have the desired effect, so a quick diagnosis—or a prenatal diagnosis, when possible—is key.

Treating Damage Caused by Fetal Hypoxia

If the infant does suffer damage to their vital organs or brain, therapy in combination with medications may help them recover to their fullest potential. For example, physical therapy and speech therapy for children with cerebral palsy may be able to help them walk and talk, allowing them much more independence as adults. Medication to reduce spasticity and control seizures may also be necessary for these children.