Causes and Risk Factors for Hypoxic-Ischemic Encephalopathy (HIE)

For many families, the news of a pregnancy brings immense joy and anticipation. But when complications arise during pregnancy or delivery, that joy and anticipation can shift toward grief and anxiety. One birth injury that we see here at our firm all too often is hypoxic-ischemic encephalopathy (HIE). It’s a serious birth injury caused by reduction in oxygen flow to an infant’s brain. The consequences are often life-altering.

Beam Legal Team is here to help families dealing with the aftermath of an HIE diagnosis when their child’s birth injury was caused by negligence.

HIE and High-Risk Pregnancy

A high-risk pregnancy occurs when a mother or baby faces conditions that increase the likelihood of complications. Medical conditions, age-related factors, and infections can contribute to a pregnancy becoming high-risk. These types of pregnancies should be actively monitored.

Common Risk Factors for High-Risk Pregnancy

• Maternal Conditions: Conditions like hypertension, preeclampsia, and gestational diabetes put extra strain on the mother’s body, which can decrease blood flow to the baby.
• Age-Related Risks: Advanced maternal age (35+) and teenage pregnancies may complicate delivery.
• Infections: Certain infections during pregnancy can hinder fetal development and affect oxygen delivery.

How High-Risk Pregnancy Increases the Risk of HIE

In a high-risk pregnancy, various conditions can interfere with the critical supply of oxygen and nutrients to the developing baby, increasing the likelihood of hypoxic-ischemic encephalopathy (HIE). This lack of oxygen can stem from maternal health issues or pregnancy complications that impact the way the placenta functions and subsequent fetal development. For example, conditions such as maternal hypertension or preeclampsia can disrupt blood flow through the placenta, reducing the supply of oxygen-rich blood to the baby.

Premature birth is another significant risk factor. Babies born before term have underdeveloped lungs and circulatory systems, making it harder for them to maintain adequate oxygen levels on their own. The earlier a baby is born, the greater the likelihood that their organs, including the brain, will not receive the oxygen they need, leading to increased risk for brain injuries such as HIE. These conditions, individually or in combination, can create a domino effect of challenges that may result in oxygen deprivation.

Preventive Measures for High-Risk Pregnancies

Effective prenatal care is essential for managing high-risk pregnancies and reducing the risk of hypoxic-ischemic encephalopathy (HIE). Routine check-ups help healthcare providers monitor the mother’s blood pressure and glucose levels, as well as fetal growth.

High-risk pregnancies often require frequent ultrasounds or tests to ensure proper oxygen and nutrient flow. Taking these proactive measures can mitigate risks associated with conditions like preeclampsia and gestational diabetes. In some cases, a planned cesarean delivery or medication to support fetal lung development may further help prevent complications. The goal should always be to provide the safest environment for the mother and baby.

HIE from Umbilical Cord Issues

Umbilical cord issues are another major cause of complications that can lead to HIE. These complications restrict oxygen and have devastating consequences if not handled carefully and swiftly.

Types of Umbilical Cord Issues That Cause HIE

• Cord Prolapse: The umbilical cord can slip into the birth canal before the baby. This compresses it and cuts off blood flow.
• Nuchal Cord: If the cord wraps around the baby’s neck, it may restrict oxygen flow.
• Cord Compression: Pressure on the umbilical cord during labor can significantly impact the baby’s oxygen levels.

Prevention and Management of Umbilical Cord Issues

Fetal monitoring during labor can help healthcare providers detect cord problems early. Early detection allows for emergency interventions like a cesarean section to prevent prolonged oxygen deprivation.

HIE from Placental or Uterine Complications

The placenta and uterus are critical to providing oxygen to the fetus. An issue with either can interrupt oxygen delivery to the baby and lead to HIE.

Common Placental and Uterine Complications

• Placental Abruption: Premature separation of the placenta
• Placental Insufficiency: Chronic low oxygen levels due to reduced placental function
• Uterine Rupture: A tear in the uterus that causes dangerous blood loss from the mother and a decrease in blood pressure that drastically reduces blood flow to the fetus

Treatment Options for Placental and Uterine Complications

Placental and uterine complications greatly increase the risk of HIE. Fortunately, early detection and intervention can reduce these risks. When signs of placental or uterine dysfunction are identified, healthcare providers can act immediately to protect the health of both mother and child.

Common treatment options include:

• Routine Monitoring and Ultrasounds: Regular ultrasounds and Doppler studies help assess placental health, monitor blood flow to the fetus, and detect any signs of dysfunction.
• Early Delivery: When oxygen deprivation risk is high, medical providers can induce labor or schedule an emergency cesarean delivery.
• Corticosteroid Treatment: When preterm delivery is expected, corticosteroids may be given to the mother to speed up the development of the baby’s lungs.

HIE from Cervical Issues

Cervical issues during pregnancy and labor pose serious risks to both mother and baby. The cervix plays a critical role in maintaining a safe environment for fetal development until the time of birth. However, certain cervical conditions can lead to premature labor or prolonged delivery. Both situations increase the risk of oxygen deprivation for the baby. Just like every possible risk during pregnancy and delivery, prompt recognition and careful management of these issues are essential for minimizing HIE risks.

Cervical Issues Contributing to HIE

• Incompetent Cervix: An incompetent or weakened cervix may open too early. This can trigger premature labor.
• Cervical Infections: Infections affecting the cervix can lead to inflammation and complications that heighten the risk of labor complications and fetal distress.
• Birth Canal Obstructions: Obstructions in the birth canal may result in prolonged delivery which increases the risk of oxygen deprivation.

Preventing Cervical Issues to Reduce the Risk of HIE

Here are some of the most effective preventative cervical issue measures:

• Regular Cervical Exams: Regular cervical checks help track any changes in cervical length, which can indicate premature dilation. Shortened cervix or early opening can signal risk factors for preterm labor.
• Cerclage Procedures: When cervical issues are diagnosed, a cerclage procedure may be recommended. This involves stitching the cervix closed to help it remain secure to reduce the chances of premature labor.
• Treatment of Infections: Cervical infections can increase inflammation and trigger preterm contractions. Prompt diagnosis and treatment of infections with antibiotics and other measures can help reduce risks.

HIE from Oligohydramnios and Polyhydramnios

Abnormalities in amniotic fluid levels, known as oligohydramnios (low fluid) and polyhydramnios (high fluid), pose serious challenges for a safe delivery. Both restrict the umbilical cord’s ability to deliver sufficient oxygen to the fetus. Also, both conditions can result in complications that increase the risk of HIE if not managed carefully.

Causes and Effects of Oligohydramnios on Fetal Development

Oligohydramnios can cause the umbilical cord to compress during labor. The compression reduces the flow of oxygen to the baby and can cause brain damage. Limited amniotic fluid may also restrict the baby’s movement, which can potentially affect lung and brain development. Early detection of oligohydramnios is crucial as it enables closer monitoring and timely interventions to protect the baby’s health.

How Polyhydramnios Increases HIE Risk

Just like low amniotic levels, polyhydramnios (or too much amniotic fluid) can stretch the uterus too much. This can lead to preterm labor or placental abruption. It also increases the chance of umbilical cord prolapse. Early detection is critical to the safety of the mother and child.

Monitoring and Managing Amniotic Fluid Levels

Routine monitoring of amniotic fluid levels is crucial throughout pregnancy to identify potential risks early. Effective monitoring includes:

• Ultrasound Monitoring: Regular ultrasounds help assess amniotic fluid levels and fetal development. Any abnormalities that may require intervention will show up here.
• Amnioinfusion During Labor: In cases of oligohydramnios, amnioinfusion (infusing sterile fluid into the amniotic sac) during labor can reduce the chances of umbilical cord compression.
• Early Delivery: When abnormalities in fluid levels become severe, early delivery may be necessary to protect the fetus from prolonged oxygen deprivation.

Monitoring the mother’s and infant’s health should always be a priority to medical providers. Anything less than providing an environment for the safest delivery possible is negligence. Contacting an experienced Chicago birth injury law firm is critical if you believe your child’s HIE diagnosis could have been prevented with better monitoring and care.

Contact Beam Legal Team If You’re Considering a Birth Injury Claim

If your child has been diagnosed with HIE that may have been caused by medical negligence, Beam Legal Team is here to support you in pursuing justice and securing compensation for your family’s needs. Our compassionate team understands the emotional and financial toll HIE takes on families, and we provide personalized guidance to ease your burden. Contact us today for a free consultation and let us help you explore your legal options.