Hypoxic ischemic encephalopathy (HIE) is a serious birth injury with potential lifelong complications. In this article, we’ll define the term “hypoxic-ischemic encephalopathy” and explain how it relates to birth injury law.

Key Takeaways

• Hypoxic-ischemic encephalopathy is brain damage to a newborn caused by limited blood flow and oxygen deprivation
• There are three stages of hypoxic-ischemic encephalopathy: Stage I is mild, Stage II is moderate, and Stage III is severe
• Causes of hypoxic-ischemic encephalopathy include prolonged labor, infection, premature birth, and more
• Failure on the part of a healthcare provider to meet the duty of care to do everything possible to prevent hypoxic-ischemic encephalopathy and its complications may be considered medical malpractice

What Is Hypoxic Ischemic Encephalopathy (HIE)?

Hypoxic ischemic encephalopathy (HIE) is a type of brain damage to a newborn baby caused by limited blood flow and oxygen deprivation. Hypoxic ischemic encephalopathy may also be called birth asphyxia, perinatal asphyxia, or neonatal encephalopathy.

Stages and Symptoms of Hypoxic Ischemic Encephalopathy

There are three stages of hypoxic-ischemic encephalopathy called the Sarnat stages. They are defined as follows.

• Stage I - Mild hypoxic-ischemic encephalopathy with symptoms that often disappear within 24 hours after birth. Symptoms right after birth include:
  • Frequent crying
  • Fussiness
  • Slightly decreased muscle tone 
  • Brisk deep tendon reflexes 
  • Hyperalertness
  • Trouble sleeping
  • Difficulty feeding
• Stage II - Moderate hypoxic-ischemic encephalopathy that requires close monitoring and proper treatment in order to reduce complications. Symptoms at this stage include:
  • Moro reflex 
  • Trouble breathing or apnea
  • Disinterest in sucking
  • Unusual lethargy
  • Significant hypotonia
  • Difficulty grasping with the hands
  • Seizures
  • Lower deep tendon reflexes
• Stage III - Severe hypoxic-ischemic encephalopathy that may cause permanent injury or even death. Earlier intervention is critical to improve outcomes. Symptoms at this stage include:
  • Extreme difficulty breathing
  • Vision problems
  • Depressed deep tendon reflexes
  • Delayed seizures
  • Poor blood pressure
  • Irregular heartbeat
  • No response to physical stimulus
  • Unresponsive, coma-like stupor
  • No neonatal reflexes (sucking, swallowing, grasping, Moro)
  • Generalized hypotonia 
  • Dilated, fixed, or unresponsive pupils

Causes of Hypoxic Ischemic Encephalopathy

Potential causes of hypoxic-ischemic encephalopathy include:

• Prolonged labor - Uterine contractions during labor compress the placenta and umbilical cord that supply oxygen to the fetus. As such, prolonged labor can increase the risk of hypoxic-ischemic encephalopathy.

• High-risk pregnancy - Improperly monitoring pregnant parents with conditions such as preeclampsia and gestational diabetes may lead to prolonged, difficult labor.

• Infections - Infections can spread from the pregnant parent to the baby during labor and delivery.

• Premature birth - Premature babies are at a higher risk for hypoxic-ischemic encephalopathy because their lungs are underdeveloped.

• Umbilical cord complications - Anything that compresses the umbilical cord or reduces its function increase the risk of hypoxic-ischemic encephalopathy.

• Placental or uterine complications - Placental abruption, placenta previa, placental insufficiency, and uterine rupture can also block the flood of oxygenated blood to the fetus.

• Medications - Contractions induced by medications such as Pitocin can be so strong and frequent that they deprive the fetus of oxygen.

Hypoxic Ischemic Encephalopathy and Birth Injury Law

Hypoxic-ischemic encephalopathy is a very serious birth injury that can lead to lifelong complications including:

• Death
• Permanent brain damage
• Physical disabilities
• Cognitive impairment

It is the medical team’s duty to do everything in their power to meet the standard of care and reduce the risk of hypoxic-ischemic encephalopathy. This includes monitoring the pregnant person and responding to any issues accordingly, conducting proper fetal heart rate monitoring, working to prevent premature birth, and more. If a baby is born with hypoxic-ischemic encephalopathy, doctors must respond promptly to treat it in order to reduce the risk of complications.

A failure to meet the duty of care is considered negligence and, when it leads to hypoxic-ischemic encephalopathy, may constitute medical malpractice. If your baby experienced hypoxic-ischemic encephalopathy or any complications thereof due to the actions or mistakes of a healthcare provider, you may be eligible for compensation for your losses. It is recommended that you speak to an experienced birth injury lawyer to learn more about how to proceed with your case.