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Hypoxic-Ischemic Encephalopathy (HIE)

What is Hypoxic-Ischemic Encephalopathy (HIE)?

Perinatal asphyxia, clinically known as Hypoxic-Ischemic Encephalopathy (HIE), is a disorder caused by acute or subacute brain injury. This brain injury is due to a lack of oxygen and blood flow to the brain during labor or delivery. Perinatal asphyxia is responsible for a large number of permanent injuries and deaths of babies every year. If your child suffered a brain injury during labor or delivery, speak to one of our Chicago birth injury lawyers from our firm experienced in HIE. Below, we explain the causes, signs and common treatments of HIE.

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What Causes Hypoxic-Ischemic Encephalopathy?

Hypoxic-ischemic encephalopathy (HIE) is caused by oxygen or blood flow deprivation to the brain during labor or delivery. The disorder can be acute or occur over a period of time (instead of chronic), depending on the length of time the infant was deprived of oxygen or blood flow. The disorder can also be regional or global, depending on the area of the brain affected. The outcome of hypoxic-ischemic encephalopathy depends on different factors. These factors include, but are not limited to:
  • Severity of the injury
  • Age of the child
  • Availability of high-level care
Newborns with severe hypoxic-ischemic injury may often be diagnosed with cerebral palsy. Your child’s doctor can help determine the prognosis of his or her injury.
HIE may occur due to prenatal complications, or complications during the labor and delivery process. Complications may include, but are not limited to:
  • Maternal infection
  • Preeclampsia
  • Uterine rupture
  • Placental abruption
  • Fetal distress
  • Umbilical cord compression
  • Delayed cesarean section
  • Improper use of vacuum or forceps
Medical negligence and/or medical malpractice by healthcare providers may also result in an HIE injury. Examples include, but are not limited to failure to:
  • Perform and/or interpret a non-stress test or fetal monitoring strip
  • Recognize and/or treat maternal infections
  • Use and/or monitor the use of oxytocin/Pitocin
  • Diagnose or respond to fetal distress
  • Recommend or perform a necessary cesarean section

What Are Common Signs of Hypoxic-Ischemic Encephalopathy?

A hypoxic-ischemic injury can occur during labor and delivery. A newborn who suffers from a hypoxic-ischemic injury may show signs immediately after birth. Signs include, but are not limited to:
  • Lack of crying or excessive crying
  • Sleepiness
  • Seizure activity
  • Poor muscle tone
  • Loss of reflex
  • Difficulty breathing or maintaining temperature
  • Immediate resuscitation
  • Low APGAR scores
  • Irregular heart rate or blood pressure
  • Organ dysfunction
  • Vision problems
  • Hearing problems
Lab findings may include an acidic arterial cord blood gas reading below 7.2, anemia, and hyperbilirubinemia.
When blood flow to the brain is disrupted, a series of events is set in motion that results in cellular damage. There is a specific period of time that if blood flow is restored, the reintroduction of oxygen and blood flow into an abnormal environment triggers additional events that produce further brain damage. This paradoxical phenomenon is called reperfusion injury. Clinically, the infant may have a period of normal behavior before rapidly deteriorating.

What Are Common Treatments for Hypoxic-Ischemic Encephalopathy?

A newborn who has experienced hypoxic-ischemic injury will often undergo an MRI or CT scan to determine the extent of the injury. If the child shows seizure-like activity, an EEG will be performed. Seizure-like activity may include fixed gaze, repetitive movements, or bicycling of the legs. Treatment for the disorder includes:
  • Maintaining adequate ventilation and blood perfusion
  • Adequate fluids
  • Phototherapy for jaundice
  • Avoidance of hyper- and hypoglycemia
  • Avoidance of fever (as this can increase reperfusion injury)
  • Treatment of seizures with anti-seizure medication
  • A 72-hour head or body cooling protocol to help avoid secondary reperfusion injury (depending on the severity of the condition)

Contact a Birth Injury Lawyer From Our Firm Experienced in Hypoxic-Ischemic Encephalopathy (HIE)

If you believe your child has suffered a Hypoxic-Ischemic Encephalopathy (HIE) injury, our birth injury lawyers may be able to help you.
Call us at (877) 262-9767 or contact us online to schedule a free consultation. We represent families nationwide and have offices in Chicago IL, Baltimore MD, New York NY, and Wilmington DE.