What Is Hypoxic-Ischemic Encephalopathy (HIE)?

Hypoxic-Ischemic Encephalopathy, or HIE, is a form of brain damage that happens when the brain cannot get enough oxygen or blood. There are many causes and the consequences are dire. Many babies die of HIE each year. Surviving babies may suffer severe disabilities.

Worse, many cases of HIE could be prevented or minimized with proper prenatal care and a skilled delivery team. If your baby has had HIE, it’s worth your time to speak with a hypoxic-ischemic encephalopathy lawyer to see if you have a malpractice claim.

What Causes Hypoxic-Ischemic Encephalopathy?

HIE is a problem that can occur during pregnancy, labor, and soon after delivery. Several causes and risk factors could create HIE in a baby. Your doctor should warn you about these risks if you have them during pregnancy, and be prepared to take action if they turn into HIE. They include:

• High-risk pregnancy factors, like high blood pressure, alcohol/drug use, and previous c-sections
• Fetal-maternal hemorrhage, which creates blood loss in the mother and baby
• Placental problems, like placental insufficiency, abruption, previa, and clotting
• Uterine rupture from trauma or previous c-sections
• Umbilical cord issues, like prolapse, wrapped cord, true knot, and underdeveloped cord
• Labor and delivery problems, like shoulder dystocia
• Clotting disorders
• Breathing problems in the baby
• Blood sugar problems in the baby
• Meconium aspiration syndrome
• Infections in the baby or mother
• Premature birth, especially before the lungs are completely developed

Symptoms of HIE in Progress

Anything that prevents a baby from getting enough oxygen or blood to the brain causes HIE, so doctors must take care to watch for signs of fetal distress that show it is happening. Some symptoms include:

• Breathing problems
• Too much acid in the body
• Low heart rate
• Unusual movements or seizures
• Low muscle tone
• Blue or pale skin
• Poor reflexes
• Stained meconium

Doctors and nurses use a test called the Apgar test to check for many of these symptoms. It should be given at least twice at one minute past birth and five minutes past birth. If a baby has a low score, that’s a sign they may be experiencing HIE or another serious birth injury.

Doctors will run additional tests like MRIs and electroencephalograms, and begin lifesaving measures if a baby doesn’t pass Apgar tests. They must take swift action to avoid the consequences of hypoxic-ischemic encephalopathy. If HIE is present, doctors have about six hours to start treatment to avoid the worst damage.

How Is HIE Treated?

First, they must fix the underlying cause of HIE to improve symptoms, but permanent damage can happen as HIE continues. This happens both in the initial stage of the disease and around 6-24 hours later when the brain tries to clear out dead cells and neurotoxins. This second injury phase is known as a reperfusion injury.

The current best treatment for reducing further injury and protecting the brain from the effects of HIE is therapeutic hypothermia. Your doctors must start this within six hours of birth. It can reduce the chances of death or severe disability, but it is not a cure for HIE. However, it is so effective in reducing damage that it’s considered medical malpractice to provide it in time.

Assuming your baby survives their episode of HIE, the next phase of treatment will depend on the damage they had. They may need treatment for organ damage in the short term, but many brain-related problems can arise over the next few years. These include:

• Epilepsy
• Cerebral palsy
• Intellectual disabilities
• Developmental delays
• Speech disorders
• Sensory processing issues
• Learning disabilities

To treat these, doctors may prescribe therapies like:

• Feeding and swallowing therapy
• Vision or hearing correction
• Seizure treatments
• Physical, speech, or occupational therapy
• Behavioral therapy

What Is the Prognosis of Hypoxic-Ischemic Encephalopathy?

Doctors will use a ranking system of mild, moderate, and severe to say how bad a child’s hypoxic-ischemic encephalopathy was, but there are many factors that affect how severe HIE is, including:

• How much oxygen deprivation there was
• How long the oxygen deprivation lasted
• The baby’s condition prior to HIE (e.g., premature, infected)
• When and whether the baby received therapeutic hypothermia

The prognosis afterward is tricky to predict because the cell damage caused by HIE is unpredictable. Doctors can use tests to reveal some of the damage, but you may not know how much HIE has affected your baby until they get older.

Children undergo developmental milestones at certain ages. If your baby starts missing these, that’s a sign they may have had HIE. The care they get during this time can make a world of difference for their future, but paying for that care can get expensive.

HIE and Medical Malpractice

Medical negligence can cause hypoxic-ischemic encephalopathy, so you may be eligible for compensation if it has happened to your child. For example, if a doctor didn’t notice signs of fetal distress, or a nurse didn’t administer Apgar tests in time, you may have a case.

Your medical team may also have missed a mild case of HIE that you wouldn’t know about until your child misses milestones. Birth injury lawyers with experience in HIE can examine your child’s medical records and see if there was a problem with your treatment.

If HIE caused your child’s disabilities and a lawyer finds that malpractice caused your child’s HIE, you can demand compensation to pay for the care your child needs. You can also demand wrongful death compensation for children who die of HIE caused by negligence.

Final Thoughts

Hypoxic-ischemic encephalopathy is an extremely serious medical condition caused by a lack of oxygen or blood to the brain. If you suspect malpractice caused your child’s HIE, contact the Birth Injury Lawyers Group for a free consultation.