What is Birth Asphyxia?
Birth asphyxia, also known as perinatal asphyxia or hypoxic-ischemic encephalopathy (HIE), is a medical condition that occurs when a newborn baby’s brain doesn’t receive enough oxygen before, during, or immediately after birth.
Asphyxia is a condition that occurs when the body is deprived of a sufficient amount of oxygen. In most cases this can be caused by some form of choking, however, it can also be a common problem that occurs during the normal birthing process. In cases where the infant does not receive the proper amount of oxygen, it can result in a buildup of acid throughout the body which can cause them to suffer from an improperly functioning body, but the possibility of permanent damage. The extent of the damage sustained by the infant will be largely dependent on the length of time that they were left without correct oxygen levels.
The incidence of birth asphyxia in California has decreased dramatically in recent years. In 1991, the incidence was 14.8 per 1000 live births. By 2000, the incidence had decreased to 1.3 per 1000 live births. The reasons for this decline are unclear but may be due to improved perinatal care. There are many risk factors for birth asphyxia, including:
- Premature birth
- Low birth weight
- Congenital anomalies
- Maternal health problems, such as high blood pressure or diabetes
- Problems during labor and delivery, such as prolonged labor or cord prolapse
The symptoms of birth asphyxia can vary depending on the severity of the condition. Some babies may show no symptoms at all, while others may have seizures, poor muscle tone, or respiratory distress.
Causes of Birth Asphyxia
While asphyxia is often related to injuries sustained by adults and teenagers (ex: from inhalation of carbon monoxide, seizures, drowning, and other tragic accidents), it can also occur during the delicate stages of the birthing process. The first moments of life are incredibly important and if they are not treated correctly, it can result in the child receiving less than an adequate amount of oxygen. This may come from several different issues that occur during birth. For example, the child may have a mother who lacks a sufficient amount of oxygen in her blood – this can affect a child without any outside interference.
Other causes of birth asphyxia include a placenta that separates too soon, anemia, as well as issues with the umbilical cord – some cases even involving an umbilical cord wrapping around the child’s throat and causing them to choke. Other issues with the mother can result in asphyxia, including high or low blood pressure or serious infections. While some of these can be attributed to circumstances outside of the realm of human control, there are instances that can be caused by faulty or low-quality medical care. If a medical professional does not properly diagnose the symptoms of asphyxia and act quickly and appropriately, it can cause more severe issues, as well as delay the necessary treatment of the issue.
The causes of birth asphyxia can be divided into two categories:
- Antepartum causes: These are factors that can affect the baby’s oxygen supply before birth. They include:
- Premature birth
- Low birth weight
- Congenital anomalies
- Maternal health problems, such as high blood pressure or diabetes
- Intrapartum causes: These are factors that can affect the baby’s oxygen supply during birth. They include:
- Prolonged labor
- Cord prolapse
- Difficult delivery
- Maternal health problems that develop during labor, such as preeclampsia or eclampsia
In some cases, the cause of birth asphyxia is unknown.
Symptoms of Asphyxia During Labor & Delivery
The common symptoms of birth asphyxia include the following:
- Breathing of the infant is non-existent or weak;
- The infant has dismal muscle tone;
- There is an abnormal or weak heart rate;
- Infant is suffering from seizures;
- There is pressure from the umbilical cord;
- Skin is either blue in color or extraordinarily pale; and
- Low heart rate or exorbitant amounts of acid in the blood.
If you notice any of these symptoms in your baby, it is important to seek medical attention immediately. Birth asphyxia is a serious condition that can lead to long-term health problems, but early treatment can improve the chances of a good outcome. Here are some additional symptoms that may be seen in babies with birth asphyxia:
- Low blood pressure
- High blood pressure
- Abnormal heart rate
- Irregular breathing patterns
- Abnormal reflexes
- Poor feeding
- Vomiting
- Diarrhea
- Jaundice
- Seizures
- Developmental delays
Any of the above symptoms should immediately alert the medical professional that asphyxia is occurring so that they can begin treatment without delay. The first stage of the injury will occur during the first few minutes of the infant being asphyxiated. This will result in the beginning stages of damage to the cells. Several days or weeks after the injury has been sustained, the child will experience the second stage. This stage is commonly known as a “reperfusion injury” and occurs after the blood flow of the newborn has returned to normal stages. The cells which had previously been damaged can release toxins into the bloodstream at this type, causing further damage and injury to the newborn.
Diagnosis of Birth Asphyxia
If the above symptoms are noted, there are several tests that can be run to help determine and diagnose the condition. The diagnosis of birth asphyxia or hypoxic-ischemic encephalopathy (HIE) is based on a combination of clinical signs, medical history, and specialized diagnostic tests. Here are some common methods used for the diagnosis of birth asphyxia:
- Clinical Assessment: The healthcare provider will evaluate the newborn’s medical history, including the circumstances surrounding the birth, maternal health, and any signs of distress during labor. They will also perform a thorough physical examination, looking for specific signs and symptoms associated with birth asphyxia.
- Apgar Score: The Apgar score is a quick assessment of a newborn’s well-being performed at 1 minute and 5 minutes after birth. It evaluates the baby’s heart rate, respiratory effort, muscle tone, reflexes, and skin color. A low Apgar score (typically less than 7) at 5 minutes may indicate birth asphyxia.
- Blood Gas Analysis: Blood samples may be taken from the newborn’s umbilical cord or through arterial puncture to measure the levels of oxygen, carbon dioxide, and acid-base balance. Birth asphyxia can result in low oxygen levels (hypoxemia) and high carbon dioxide levels (hypercapnia) in the blood, as well as metabolic acidosis. If they are proven to be less than 7.00 in the umbilical cord blood, it could be proof that the child has been asphyxiated.
- Neurological Examination: A detailed assessment of the newborn’s neurological function is essential to diagnose birth asphyxia. This examination involves evaluating muscle tone, reflexes, response to stimuli, level of consciousness, and presence of abnormal movements or seizures.
- Imaging Studies: Imaging techniques like cranial ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans may be performed to assess the extent of brain injury and identify any structural abnormalities or areas of reduced blood flow in the brain.
Other ways of diagnosing the condition include simple observation for the more severe symptoms – including seizures, coma and abnormal blood pressure. If asphyxiation is diagnosed, it will be absolutely vital that immediate steps are taken to treat the issue. Depending on the circumstances of the case (including age of the baby, severity of the condition, expectations and more), treatment may range from anything as simple as introducing more oxygen into the blood of the delivering mother to performing an emergency Caesarean section. Other treatment options include manually supporting the child’s breathing, as well as extracorporeal membrane oxygenation.
Treatment of Birth Asphyxia
The treatment of birth asphyxia depends on the severity of the condition. Mild cases may only require oxygen therapy, while more severe cases may require more intensive care, such as mechanical ventilation or extracorporeal membrane oxygenation (ECMO).
- Oxygen therapy is the most common treatment for birth asphyxia. It is used to increase the amount of oxygen in the baby’s blood. Oxygen therapy can be given through a mask, nasal cannula, or endotracheal tube.
- Mechanical ventilation is used to help the baby breathe. A breathing tube is inserted into the baby’s airway and a ventilator is used to force air into the lungs. Mechanical ventilation can be used for a short period of time or for a longer period of time, depending on the severity of the baby’s condition.
- Extracorporeal membrane oxygenation (ECMO) is a life-support treatment that is used for the most severe cases of birth asphyxia. ECMO works by taking over the baby’s heart and lungs. Blood is removed from the baby’s body, oxygenated outside the body, and then returned to the baby’s body. ECMO is a very complex treatment and is only used in a few specialized centers.
In addition to medical treatment, babies with birth asphyxia may also need supportive care, such as nutrition, hydration, and pain relief. The long-term outcome of babies with birth asphyxia varies depending on the severity of the condition. Some babies make a full recovery, while others may have long-term health problems, such as cerebral palsy, learning disabilities, or developmental delays.
Consult with Pacific Attorney Group’s Birth Injury Lawyer
If your child has suffered from asphyxia during the birthing process, it can have significant and long-lasting consequences. This has been tied to children suffering from cerebral palsy, as well as development delays and disabilities. While this injury cannot always be tied to medical malpractice, it is extremely important that you consult with a knowledgeable legal professional who will be able to evaluate your case and determine the best course of action.
If it is determined that the child had been injured due to the actions of a medical professional, we encourage you to get the involvement of a cerebral palsy lawyer from the Pacific Attorney Group. Over the years, our firm has been proven as advocates for the rights of the injured – you can be confident knowing that we will go above and beyond in our efforts to protect your rights. Our skilled birth injury lawyers have what it takes to fight for you.