Hypoxic-ischemic encephalopathy (HIE) is a brain injury caused by a lack of oxygen to the brain. It is often the result of medical malpractice that occurs during a pregnancy, labor, or delivery. It can permanently harm a child and the way they develop. HIE affects many infants every year from completely preventable medical mistakes.
Many families and children deal with the symptoms of HIE for the rest of their lives. It can lead to permanent disability, devastating symptoms, and financial hardships for the child’s family.
What Is Hypoxic-Ischemic Encephalopathy?
Hypoxic-ischemic encephalopathy is a common birth injury typically caused by a severe lack of oxygen to the brain. It can permanently alter how the brain functions. It usually affects newborns who had a traumatizing birth, but it may also affect older people who suffer severe respiratory distress later in their life.
Doctors and health care providers may also refer to HIE by names such as:
- Perinatal hypoxia
- Birth asphyxia
- Neonatal encephalopathy
Common Types of HIE
Doctors typically diagnose a child with three grades of HIE: mild, moderate, or severe. These grades are associated with the child’s neurological outcomes and the level of treatment needed.
Every type of HIE requires emergency medical treatment and long-term care. Less severe cases may be fully treated or lead to minor disabilities. Severe cases can cause extreme trauma, permanent disability, or even wrongful death.
Symptoms of HIE
Children typically suffer a wide range of symptoms caused by HIE. Mild or moderate symptoms typically include:
- Difficulty feeding
- Irritability and difficulty sleeping
- Weak cry
- Pale gray or blue tone to the child’s skin, lips, and fingers called cyanosis
- Floppy or weak muscle tone
- Overly tense muscles
HIE can also manifest with much more severe symptoms, such as:
- Lack of response to sound or touch
- Poor reflexes
- Seizures and other severe muscle contractions
- Loss of consciousness
- Abnormal or shallow breathing
- Slow or irregular heartbeat
Parents should immediately call 911 and get emergency medical attention if a child displays any of these symptoms. Acting quickly may help prevent further damage and limit the harm HIE can cause.
Causes of Hypoxic-Ischemic Encephalopathy
Several problems during labor, delivery, or even during pregnancy may cause HIE. Too often, HIE is caused by medical errors, lack of attention, or other negligence by health care professionals.
Injuries During Pregnancy
HIE may be caused during pregnancy for reasons such as:
- Maternal diabetes
- Infections passed from the mother to the fetus
- Lesions or masses in the baby’s lungs
- Drug or alcohol abuse
- High blood pressure and preeclampsia
- Uterine rupture
- Placental detachment
- Fetal anemia
- Blunt-force trauma that causes a lack of oxygen to the brain
Injuries During Labor or Delivery
Injuries often occur during labor or the child’s delivery. Common causes of HIE during this stage include:
- Bleeding from the placenta
- Ruptured placenta
- Wrapped umbilical cords or other umbilical cord accidents
- Mother’s low blood pressure
- Abnormal fetal position during birth, such as a breech birth
- Prolonged labor
- Delayed C-sections
Injuries After Birth
Medical malpractice and other causes after birth may also cause HIE, such as:
- Traumatic brain injuries
- Extreme premature birth, especially if born before 28 weeks
- Low blood pressure
- Severe lung or heart disease
- Infections such as sepsis or meningitis
Complications Associated With HIE
HIE is an extremely serious medical condition that can lead to severe symptoms and further complications. It might even be fatal. Brain damage complications associated with HIE include some of the following:
- Intellectual disabilities and cognitive problems
- Developmental delays or missed milestones
- Hearing and vision loss
- Growth problems
- Susceptibility to infections
- Cerebral palsy
- Epilepsy
- Difficulty paying attention or attention-deficit disorder
While the damage is done, many of these complications will not appear for many years. Some may not even be noticeable until a child starts school. Teachers or medical professionals may notice that the child misses developmental and cognitive milestones other similarly aged children meet.
How Is HIE Diagnosed?
HIE is a medical emergency often diagnosed during childbirth. It may even be identified before the child is born. Responsible health care providers prepare to treat this condition, especially after a difficult birth. To diagnose this condition, doctors complete a physical exam. They look for the signs and symptoms of HIE and then confirm a potential diagnosis by running applicable tests.
These tests may be performed either before or after birth. They often include:
- Placenta blood test
- CT scan
- EKG
- Fetal heart monitoring
- Imaging tests, such as MRI or ultrasound
- Electroencephalogram (EEG)
- Newborn wellness assessment and Apgar score
- Umbilical cord blood gas test
Additional tests may also be needed to diagnose if a child has HIE. This condition often presents in various ways and may have delayed symptoms, making it difficult for doctors to recognize the condition initially.
Long-Term Management and Treatment of HIE
Children who suffer from HIE often require treatment and long-term management of their condition. This treatment may alleviate or reduce many of the symptoms of the condition. However, for many children, the damage is lifelong and permanent. Health care providers may help treat the condition by:
- Using therapeutic hypothermia to cool the child’s body, followed by rewarming to protect the brain from further injury
- Supportive treatments of blood and oxygen flow limitations, such as through a mask or nasal cannula
- EEG monitoring to detect seizures
- Physical and occupational therapy
- Speech therapy
- Assistive devices such as hearing aids or special glasses
- Early intervention in the child’s education
Every child is different and requires personalized medical attention to deal with their symptoms. Parents and health care providers can work together to find the best treatment options for their children.
Birth Injuries Lead to Hypoxic-Ischemic Encephalopathy
The effects of HIE can be devastating to both the child and their family. It can lead to lifelong disabilities that limit their quality of life and add a great deal of stress to everyone’s life. It can also create great financial hardships that affect everyone. Compensation through a birth injury lawsuit may help a family put their life back together after an HIE diagnosis.
