What Is Hypoxic Ischemic Encephalopathy?

Most women enter the labor and delivery unit with a birth plan and every expectation of delivering a healthy baby. When the unexpected occurs, birth plans suddenly change and expectations alter. One unplanned outcome of some childbirths is a baby diagnosed with hypoxic ischemic encephalopathy (HIE). This birth injury occurs in about 1.5-2.5 live births per 1,000. Doctors consider hypoxic ischemic encephalopathy to be one of the most serious birth injuries affecting full-term infants. Even with today’s advances in obstetric care and fetal monitoring, our Louisville birth injury lawyers still see cases of HIE impacting families across the U.S.

How Does Hypoxic Ischemic Encephalopathy Occur?

Hypoxic Ischemic Encephalopathy is a brain injury that occurs when a baby’s brain doesn’t receive the critical oxygen or blood flow it requires to function, leaving damage that ranges from mild to severe. HIE can occur at any time during a woman’s pregnancy, during the labor and delivery process, or immediately after birth. Common causes of HIE during pregnancy include:

  • Disruption of blood flow through the placenta
  • Preeclampsia
  • Maternal diabetes with related vascular disease
  • Fetal infections
  • Severe fetal anemia
  • Drug or alcohol abuse by the mother
  • Infant heart or lung disease

Even when none of the above conditions are present, a baby’s brain can become deprived of oxygen during labor and delivery, resulting in hypoxic ischemic encephalopathy. Causes of HIE during childbirth include:

  • Placental abruption
  • Uterine rupture
  • Problems with the umbilical cord
  • Excessive placental bleeding
  • Prolonged stages of labor
  • Breech birth position
  • Severe low blood pressure in the mother

In some cases, our specialized HIE lawyers in Louisville have seen cases of injury occurring after birth due to any of the following:

  • Premature birth with under-developed lungs
  • Heart or lung problems
  • Respiratory failure or heart failure
  • Severe infection
  • Trauma to the head
  • Extreme low blood pressure in the infant

When signs of fetal distress occur during pregnancy or childbirth or the infant shows fetal distress after delivery, a doctor may suspect HIE. 

Diagnosing Hypoxic Ischemic Encephalopathy

If a doctor suspects HIE in a newborn, a neurologist will run tests including MRI-brain imaging, and monitoring for seizures or other signs of brain dysfunction. Common signs of HIE include:

  • Stiffness or floppiness after birth
  • Under-reaction or over-reaction to stimuli
  • Lack of normal reflexes
  • Seizures
  • Breathing problems
  • Decreased alertness

Diagnosing HIE also includes determining the severity of the damage, which depends on how long the infant’s brain was deprived of oxygen. Mild HIE symptoms include irritability, crying, poor sleep, and feeding problems that resolve within 24 hours after birth. Moderate HIE includes poor reflexes, including sucking and grasping reflexes, lethargy, apnea, and seizures. In severe HIE, the affected infant has acute symptoms such as seizures, breathing problems, dilated pupils, problems with heart rate and blood pressure, absence of reflexes, and coma.

What Are the Long-Term Impacts of Hypoxic Ischemic Encephalopathy in Infants?

Doctors treat cases of HIE immediately after birth through a variety of interventions including lowering the baby’s body temperature for up to three days to minimize the severity of the damage by controlling inflammation.

Depending on the severity of the HIE, a child diagnosed with mild hypoxic ischemic encephalopathy may have no noticeable long-term health impacts. Moderate to severe HIE can cause developmental delays, cerebral palsy, epilepsy, or cognitive impairment. Babies diagnosed with severe HIE may have breathing problems that lead to death or they may go on to experience cerebral palsy and severe cognitive impairment and intellectual disability.

When a child’s HIE was preventable if only the medical providers had identified and promptly addressed the problem during the labor process, parents may seek compensation for damages with help from a Louisville medical malpractice lawyer. Damages in these cases can include:

  • Medical costs
  • Special education costs
  • Lost wages when a parent must leave a job to care for a disabled child
  • Grief, anguish, and emotional trauma

There are many resources for parents of children diagnosed with HIE, including the HIE Help Center.