Hypoxic-Ischemic Encephalopathy (HIE) Facts

HIE, Hypoxic-ischemic encephalopathy, is often referred to as “Neonatal Encephalopathy” or “Birth Asphyxia.” HIE is a form of infant brain damage that is unfortunately caused by medical malpractice in many instances.

Hypoxic-ischemic encephalopathy (HIE) covers a number of neurological birth injuries, caused by a lack of oxygen to the baby’s brain during birth or in the moments leading up to birth, when the baby’s blood does not have sufficient oxygen. 

Why does Hypoxic-Ischemic Encephalopathy Happen?

Hypoxic-ischemic encephalopathy (HIE) covers a number of neurological birth injuries and unfortunately, there are multiple reasons why HIE develops. Many of the problems are related to unexpected labor and delivery problems; however, other factors can lead to HIE include high-risk pregnancy conditions. Although there are causes of Hypoxic-ischemic encephalopathy (HIE) that are natural, the majority of HIE injuries are due to some form of medical negligence by medical professional or medical malpractice. Hypoxic-ischemic encephalopathy (HIE) is often the result of medical professionals failing to take proper precautions to prevent the occurrence of HIE. Some of the most common medical conditions and factors that occur with HIE are as follows: 

  • Improper monitoring of fetal distress
  • Preeclampsia 
  • Infections, both from the mother or the fetus
  • Errors in Anesthesia
  • Premature delivery
  • Placental Abruption
  • Placenta complications
  • Umbilical cord problems, including Prolapsed umbilical cord
  • Maternal age/obesity
  • Misuse of drugs to induce contractions

Hypoxic-ischemic encephalopathy (HIE) and Newborns

Most medical events experienced by infants and newborns are more impactful than they would be to an adult. During HIE on an infant, the newborn’s brain is denied necessary oxygen, which results in brain cells dying quickly and in large amounts. Sadly, this results in irreversible brain damage. Once identified as HIE, medical professionals will attempt intervention by “therapeutic hypothermia,” which reduces the baby’s body temperature to lower than 92 degrees, in order to reduce the temperature of the baby’s brain and prevent further damage.  By reducing the newborn’s metabolic rate, the spread of the brain damage may be slowed or reduced.

Are There Signs that HIE is Occurring?

Yes, medical professionals are trained to identify and quickly respond to HIE, in order to mitigate or prevent further injury due to HIE. Some of the most important signs of HIE include, a low APGAR score, which assesses the health of the baby post-delivery), seizures, organ or breathing issues, and refusal to feed for extended periods of time. A combination of these signs may indicate to medical professionals that an infant is suffering HIE.

In order to make a sound medical diagnosis, the medical professionals will likely use an MRI, EEG, ultrasound, and other available scans to determine, if an infant is suffering HIE. 

Unfortunately, in cases where HIE is not identified and a failure to diagnose HIE occurs, developmental disorders may be put in motion that will not be identified for years to come. Therefore, it is essential that medical professional take preventative steps to identify and responds to signs of HIE, especially, if there are other signs of trauma or indicators that an infant may be suffering HIE. 

How Prevalence is HIE?

Fortunately, most families will never experience or hear about HIE; however, it is a relatively prevalent condition: 1.5 out of 1,000 live births include a condition of HIE. In fact, scientists believe HIE is responsible for almost one-quarter of all neonatal deaths. As with most medical issues, the severity of the impact of HIE is largely dependent upon the level of insufficient blood in an infant’s brain and the duration of the episode. 

Infants are not the only victims of HIE, in fact older children and adults may suffer from lack of oxygen to the brain; however, these incidents are typically caused by a cardia event or stroke.

HIE: Is Early Detection Possible?

Hypoxic-ischemic encephalopathy (HIE) can result in life altering consequences, it can also be treated with the previously mentioned therapeutic hypothermia, which can greatly decrease the possibility of lifelong effects of HIE.  Therefore, early detection of HIE, prior to onset of serious damage, can result in reduced impact and greatly increase the likelihood of positively impact an infant’s health and future. Early detection of Hypoxic-ischemic encephalopathy (HIE) is essential. 

In order to be effective, Hypoxic-ischemic encephalopathy (HIE) treatment must begin shortly after birth. Unfortunately, this results in medical professionals only having a short window of time in order to begin effective treatment of Hypoxic-ischemic encephalopathy (HIE). Without early detection and treatment, HIE will result almost always result in brain damage.

Any newborn that was deprived of oxygen for a period of time during or before birth should be tested for HIE; however, there are other symptoms that should be considered in identifying HIE or the symptoms of Hypoxic-ischemic encephalopathy (HIE), which include the following: 

  • Problems breathing or wheezing
  • Seizures
  • Abnormal consciousness or lack of consciousness
  • Abnormal response to light
  • Trouble latching on, sucking, or swallowing when feeding
  • Low muscle tone

The APGAR test, which assesses the overall health of a newborn is one test for Tests for Hypoxic-ischemic encephalopathy (HIE). The APGAR tests the overall health of a newborn baby by evaluating multiple factors. APGAR is an acronym for Appearance, Pulse, Grimace, Activity, and Respiratory Effort. 

An MRI or CAT Scan may also be used by medical professionals to test for Hypoxic-ischemic encephalopathy (HIE). Other imaging technology may be used to evaluate brain injuries or trauma related to oxygen deprivation. Additionally, umbilical cord blood gas tests can indicate a lack of blood oxygen in the umbilical cord, which typically is associated with Hypoxic-ischemic encephalopathy (HIE). Additionally, an EEG can detect for seizures, which again is a possible symptom of HIE.  

Many of the common signs of HIE may be missed by medical professionals or not identified for months, which results in a failure to capture the window for effective intervention of Hypoxic-ischemic encephalopathy (HIE). This failure is medical malpractice. 

How do HIE Cases Develop?

Hypoxic-ischemic encephalopathy (HIE) is a form of brain damage due to a newborn suffering a reduction in effective blood oxygen levels in the brain. Many HIE cases are the direct result of medical malpractice and will have life-long consequences. The following are some of the most common cases in which Hypoxic-ischemic encephalopathy (HIE) develops:

  1. High-Risk Pregnancy and HIE

Women facing high-risk pregnancy must be carefully monitored throughout their pregnancy, as Hypoxic-ischemic encephalopathy (HIE) has a higher rate of appearing in high risk pregnancies. The most common types of high-risk pregnancy include preeclampsia and gestational diabetes. Failure to properly monitor high-risk pregnancy can result in deadly consequences for a newborn, Hypoxic-ischemic encephalopathy (HIE). Failure to properly monitor high risk pregnancies can have fatal repercussions. In cases where high risk pregnancy conditions are not given the proper level of attention and treatment, HIE may be the end result.

HIE Due to Umbilical Cord Issues

The umbilical cord, which connects mothers to babies before they are born, provide unborn babies with the essentials for growth, nutrition, and oxygen until they are born. Additionally, the umbilical cord carries away waste from the baby. Birth causes stress to the umbilical cord, which may result in compression or damage that in some cases cuts off oxygen to the fetus, which can lead to Hypoxic-ischemic encephalopathy (HIE). 

HIE Due to Placental and Uterine Issues

The mother’s placenta and uterus are essential to the fetus’ safety and oxygenation. When the placenta detaches from the uterus too soon, the baby’s blood may suffer from reduced oxygen supply. When the placenta does not deliver sufficient oxygen to the blood or the uterus is torn, Hypoxic-ischemic encephalopathy (HIE) may develop as a result.  

Other Commons Causes of HIE Development

The following are slightly less common causes of Hypoxic-ischemic encephalopathy (HIE); however, these events trigger HIE frequently enough to warrant discussion here:

  • HIE due to an Infection spreading from the mother to the baby during birth
  • HIE due to unnecessary pre-term birth. Premature babies may suffer from less developed lungs and therefore are at a higher risk of HIE. 
  • HIE due to a failure to monitor fetal distress. Heart monitors are a very useful tool in protecting a new born baby / monitoring for HIE. An infant heart monitor can detect if a baby is not receiving enough oxygen in their blood. When medical staff failed to identify reduced oxygen in the blood, HIE may result.
  • HIE may be caused simply by extreme long or stressed labor, as the baby may receive less oxygen to their blood due to the strain on the mother’s body. Medical intervention can often prevent this cause of HIE through a C-section. 
  • HIE may be caused by excessive labor inducing medications, which may cause contractions that are too violent or frequent, which can lead to an increased risk of HIE.

Principals in Neonatal Treatment of Hypoxic-Ischemic Encephalopathy (HIE)

Immediate medical intervention is necessary to improve a patient’s chances after suffering Neonatal HIE. As discussed above, “hypothermia treatment” or brain cooling is the first step in treating HIE. Hypothermia treatment reduces the baby’s overall body temperature and brain to reduce brain damage. 

Babies are laid on a cooling blanket and wear a cooling cap for roughly three days, which is uncomfortable for the baby; however, medical is given to reduce the discomfort.  The cooling cap recirculates cold water through the cap to bring the baby’s temperature down to 91 degrees, which slows the baby’s metabolic rate and reduces cell damage. Once the baby completes the cooling process their temperature is gradually increased to normal temperature. 

Hypothermia Treatment is an intense process and babies are monitored closely throughout. The baby’s heart rate, breathing and temperature are all measured. Additionally, brain activity, which is accomplished by electroencephalogram, which monitors cerebral functioning.  Small probes are placed on the baby’s skull to monitor and protect from seizures. 

A ventilator or ECMO may be used to assist with breathing during the cooling treatment for HIE to treat and protect other organs affected by the cooling process. 

Babies with HIE will receive physical, medical, and occupational therapy to address the symptoms of HIE after Neonatal Treatment is completed. With early intervention and proper treatment, babies that suffer from HIE may live completely normal lives. 

What to Do if HIE occurs due to Medical Malpractice

Oklahoma law protects victims of medical malpractice, specifically HIE victims, by providing an avenue to receive justice. It is important to retain and work with an attorney that is well versed in Oklahoma medical malpractice laws, specifically dealing with HIE medical malpractice. 

Contact – Cannon & Associates: Oklahoma Fierce Advocates for HIE Victims 

Medical malpractices cases, especially HIE cases are highly complex. It is imperative to work with an experienced Oklahoma HIE attorney. Contact Cannon & Associates for legal representation. Our attorneys have the experience and expertise needed to navigate the complex world of HIE litigation.

Founder John Cannon has been recognized as a Super Lawyer and our team of Fierce Advocates for HIE victims are ready to assist you and your family. Contact Cannon & Associates by completing the CONTACT FORM ON THIS PAGE NOW or CALL at (405) 906-4051 for a free confidential case evaluation.