Maryland Injury Lawyer Blog

Medically induced cooling of the brain can help treat damage. This relatively new procedure — the FDA approved it a little over 10 years ago —  provides the opportunity to treat babies who are suffering from hypoxic brain damage as a result of perinatal asphyxia.

We don’t totally understand exactly why brain cooling works although there are many theories that make perfect sense that are floating around out there.  But, ultimately, who cares why it works.  It appears to work on not only the brain but other vital organs that have been harmed from oxygen deprivation.

At this point, I don’t know why any hospital with a NICU would not have the ability to use cooling to protect an infant from brain damage.

Women experiencing typical pregnancies are not offered the option of inducing labor at 39 weeks.  That might change.

A recent study funded by the National Institutes of Health (“NIH”) suggests that electively inducing labor 1 week before the due date decreases the risk of complications and lead to a safer delivery.  New mothers whose labor was induced in week 39 (instead of waiting for labor to begin naturally) were less likely to require a C-section and had lower rates of preeclampsia and other complications.  The research also established inducing at 39 weeks did not increase the chances of stillbirth or other severe complications compared to mothers who were not induced.  The detailed results of this pivotal NIH study were just published in the New England Journal of Medicine: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women.

It was previously believed that early induction of labor significantly increases the likelihood of an emergency cesarean delivery in response to complications.  This made many doctors reluctant to induce any time before 40 weeks, but no comprehensive study had ever been done before.  The Pregnancy and Perinatology Branch at NIH funded the study in an effort to fill this data gap.

A neonatal stroke (also called a perinatal stroke) is defined as an interruption of blood flow to an infant’s brain that occurs between 20 weeks gestation and first 28 days after the child is born. Neonatal strokes can be ischemic or hemorrhagic.  Ischemic neonatal strokes are caused by some form of blockage in the blood vessels.  Hemorrhagic strokes occur when blood vessels rupture and bleed.

What causes a newborn to have a stroke?

Neonatal strokes are the result of some event within the body that suddenly disrupts the normal flow of blood to the baby’s brain.  In adults, the underlying causes leading to a stroke are usually high blood pressure, diabetes or some other condition.

In June 2018, a study was published in the Canadian Medical Association Journal which shows there has been an alarming increase in the rate of birth injuries resulting from forceps-assisted deliveries.  This does not surprise me because our obstetrician experts have been telling us for years that the new generation of obstetricians does not have the skill to use forceps.  If too much pressure or force is used, forceps can cause injury to both mother and baby.

What Are Forceps?

Obstetrical forceps are a surgical tool used by OB/GYNs to assist in difficult vaginal deliveries.  The forceps look like large plyers with metal spoons at the ends.  The spoons are used to basically grip the baby’s head so that the doctor can then manually maneuver the baby through the birth canal.  Sometimes, birth injury lawyers unfairly vilify forceps. But forceps are a very effective weapon with the right obstetrician.  The problem is they require a high level of skill and experience by the doctor.

Birth injuries can result in lifelong consequences for both the parents and the child. Serious birth injuries can result in permanent disabilities and a lifetime of expenses.  Birth injuries are often the direct result of medical negligence or preventable medical error by the doctors, nurses, and staff during the labor and delivery process.  When birth injuries are attributable to medical negligence, the civil legal system gives injured parties the ability to obtain financial compensation from doctors, hospitals, and their insurance carries.

If your child has suffered a birth injury, your question is where do I go from here?  What can I do to bring about the best possible outcome for my child?   If your child had not suffered a birth injury, money is important yet still pretty far down on the list of what you need to make a good life for your child.  For a child with significant birth injuries, money jumps higher on the “things you need” chart.  So if someone wonders why you are worried about filing a lawsuit instead of focusing on your child, I think bringing a meritorious birth injury claim is exactly what you do when you are putting your child’s future first.

Below are some common questions parents ask in birth injury cases.

Caput succedaneum and cephalohematoma are similar – but distinct – birth injuries which cause a baby’s head to swell. They are typically not serious and will heal themselves over a relatively short period of time.  For most worried parents, it is not a big deal if it is not coupled with a brain bleed or other cerebral insult.  But these conditions can lead to more severe complications in the absence of a prompt diagnosis, vigilance, and effective treatment. Furthermore, the possibility that one of these conditions is connected with or arising from a more serious birth injury also means that immediate medical attention should be given to diagnosing and providing any necessary treatment for these conditions.

The importance of prompt and effective diagnosis and treatment for these conditions, unfortunately, means that what would otherwise have been harmless can grow to become a more serious – sometimes life-long – condition on account of medical negligence. This can arise from failing to recognize the issue during or after delivery, a failure to provide proper treatment (such as a C-section, when warranted), or even failing to diagnose precipitating causes of the injuries prior to birth. If your child has suffered from one of one of these conditions as a consequence of medical neglect, you should be eligible to receive compensation.  Contact me if you are looking for answers about your child’s case.

I am going to walk you through some of the most frequently asked questions about caput succedaneum and cephalohematoma.

Hypoxic ischemia (also known as ischemic hypoxia, hypoxic-ischemic encephalopathy, and HIE) is brain damage which occurs when an infant does not receive enough oxygen and blood in their brain. All of our brains, but particularly a baby’s brain,  is extremely dependent on blood and oxygen to survive.  When the brain is deprived of blood and oxygen for a sufficient amount of time, it becomes permanently damaged from hypoxia and ischemia. Once permanently damaged by hypoxia and ischemia, the brain permanently fails to provide normal neurological function.  This can cause both mental and physical injuries.  Fatalities are not uncommon.  HIE caused by asphyxia is the leading cause of infant mortality in the United States.

Unfortunately, cases of hypoxic ischemia can often happen as a consequence of medical negligence. In particular, failing to accurately diagnose the condition (often through neglecting the fetal heart rate monitor), or inadequate treatment and care during the delivery process (often through failing to perform a c-section when needed) are the two biggest factors that cause hypoxia because of medical neglect.

Birth injury lawsuits have been successfully filed for the parents to receive their due compensation for the serious consequences which can stem from hypoxic ischemia. If you have any questions about hypoxic ischemia or believe you may be entitled to compensation due to this condition arising in your child as a consequence of medical neglect, you should reach out to me.