Hypoxic-ischemic encephalopathy is an extremely dangerous birth injury caused by a lack of blood or oxygen to the brain. The cells of the body begin to die because of the lack of oxygen. The brain is the most vulnerable organ to this and the most affected.
Prevention of HIE is always preferable, but there are things physicians can do to handle HIE when it is in progress to reduce the risk of death and severe injury. If these steps aren’t done, your doctor may have committed medical malpractice.
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How HIE Harms the Brain
When a cell cannot get enough oxygen or nutrients in the blood, it dies. Dead brain cells prevent the transmission of nerve impulses and neurotransmitters in the brain. If enough brain cells die, the baby could die. Death is common in severe cases of HIE.
If a physician restores blood and oxygen flow, the baby may survive. However, the dead cells are still in the brain. When they die, they create compounds that the body has to flush out. For about six hours after birth, these stay in the brain but do not cause further damage.
After that point, for about 24-48 hours, reperfusion injuries can happen. Reperfusion creates inflammation in the brain and increases pressure inside the skull. This pressure can lead to further cell injury and death. Byproducts from earlier dead cells and oxidative stress from restored blood flow can also harm the brain during this time.
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Restoring Blood and Oxygen Flow
The first thing a physician must do is restore blood and oxygen flow as soon as possible. The severity of HIE rises the longer a child doesn’t have enough of these. Different underlying causes of HIE have different treatments.
Doctors must monitor both the mother and the baby for blood and oxygen problems before, during, and after birth. The exact action depends on the cause behind HIE. For example, your doctor may need to perform an emergency C-section for umbilical cord problems, or administer blood thinners for clotting problems.
Proper care also means instructing mothers on reducing risk factors that raise the chances of HIE during pregnancy and delivery. It’s far easier to control the risk factors for HIE before it happens. Once it starts, damage piles up.
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Therapeutic Hypothermia
During the six-hour window between birth and the start of a reperfusion injury, doctors can use therapeutic hypothermia to improve the chances of your child’s survival and reduce long-term damage caused by reperfusion.
This process cools babies to 91-93 degrees Fahrenheit for three days. It is currently the only evidence-based medical intervention that reduces brain damage caused by HIE, though large studies have only been done on full-term babies (>36 weeks).
Time is of the essence with this treatment. If this procedure isn’t started within the six-hour window, reperfusion will start and cause further brain damage and potential death. Babies with severe HIE who undergo therapeutic hypothermia raise their rates of survival by 50%.
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Post-HIE Analysis
Once the danger of reperfusion has passed, the next phase is to assess the damage. Low oxygen can damage all the organs of the body, so your child may get examined for lung and heart problems. But the organ most likely to be damaged is the brain.
The brain is not a fully understood organ, so the kinds of disabilities your child could suffer will vary. Cerebral palsy and seizure disorders are common after HIE. Your child may have trouble swallowing or latching because of the damage.
Some disabilities may not appear until the child grows older and starts missing developmental milestones. At infancy, it’s too soon to tell if a child may have a learning, behavioral, or intellectual disability.
Therapy After HIE
As the unique pattern of damage of your child’s HIE is revealed, your doctors will recommend treatments. Your child may need to be hospitalized if they have breathing or heart problems. As they grow and get stronger, attention may turn toward helping with speech and learning disabilities.
The treatment of HIE and its consequences can be extremely expensive for parents, but it’s worth paying for care. Early intervention will give your child the best possible outcome after HIE. However, you may not have to pay for it all out of your own pocket.
Medical Malpractice and HIE
Stopping HIE requires your doctors to notice problems that cause it early and take action. Medical intervention can stop not every instance of HIE, but many can. It’s why hypoxic-ischemic encephalopathy cases get taken by birth injury lawyers all the time.
If a lawyer can prove your child’s HIE was because of medical negligence, you can get compensation to pay for your child’s care and the pain and suffering they’ve experienced. It is absolutely worth your time to speak with a birth injury attorney for advice. Consultations are free; the worst they can say is that you have no case.
The Birth Injury Lawyers Group connects parents of children with birth injuries to qualified medical malpractice attorneys in their states. Call the number on your screen or email us to schedule a free consultation with our experienced attorneys if you believe your physician handled your child’s HIE improperly.
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