Anoxia and Hypoxia at Birth

Bringing a baby into the world is an extremely intense and complex process for both mother and child. Although most births go smoothly, there are many instances when complications arise that can harm the infant. Two of the most potentially serious are anoxia and hypoxia.

What Are Anoxia and Hypoxia?

Without ongoing and reliable access to oxygen, human beings will die. Anoxia refers to the absence of oxygen to vital parts of the body, including to the baby’s blood, muscle groups and organs. When the brain is totally deprived of oxygen, it experiences a severe condition known as cerebral anoxia which can lead to permanent damage.

Whereas anoxia refers to a total lack of oxygen, hypoxia occurs when the body encounters low oxygen levels. These can occur throughout the system or may only happen in one area or limb. Frequently, hypoxia is seen when a baby is born prematurely, particularly when the lungs have not developed sufficiently in utero to allow for breathing in the outside world. In some of the most severe situations, a baby may develop a condition known as hypoxic ischemic encephalopathy (HIE) in which brain damage occurs due to reduced blood flow or low oxygenation in the blood.

What Are the Causes of Anoxia and Hypoxia at Birth

Of the premature and full-term babies that die each year in this country, research indicates that an estimated six out of 10 are the result of anoxic injury. One of the main causes of anoxia and hypoxia at birth is complications that occur when the umbilical cord is pinched or kinked during delivery. As a result, the baby is deprived of oxygenated blood from the placenta for a certain period of time. The longer this lasts, the more severe the potential damage can be.

Several pregnancy complications and risk factors can make a baby more susceptible to anoxia or hypoxia at birth. These include the following:

• Abnormal fetal presentation. Instead of facing head-first and rearward toward the mother’s back, the baby faces forward with abnormal positions being face, brow, breech and shoulder.
• Cephalopelvic disproportion (a mismatch between the size of the baby’s head and the mother’s pelvis that can cause failure to progress through labor.)
• Injury from vacuum extraction.
• Injury from forceps delivery.
• Errors made while resuscitating the infant.
• Prolonged labor.
• Placental abruption (separation of part or all of the placenta from the uterine wall).
• Low levels of amniotic fluid.
• Umbilical cord prolapse (occurs when the umbilical cord slips down in front of the baby after the mother’s water has broken. It can then come through the open cervix.)
• Compression of the umbilical cord close to the baby.

Additionally, there are several maternal health factors that can lead to oxygenation difficulties. These include:

• Preeclampsia.
• Gestational diabetes.
• Maternal obesity.
• Advanced maternal age.
• Maternal infections.

Mothers with any of these risk factors should be especially vigilant throughout their pregnancy and should make it a point to share their complete medical history with their entire birthing team.

What Are the Symptoms of Anoxia and Hypoxia?

The first warning sign of anoxia or hypoxia usually is that the baby cannot breathe or is having difficulty doing so. If oxygen deprivation is prolonged, seizures may begin.

In some cases, a child’s caregivers might not recognize that oxygen deprivation has occurred until months or even years later. Symptoms that families may recognize include the following:

• Developmental delays.
• Balance problems.
• Movement difficulties.
• Memory loss.
• Speech problems.
• Visual concerns.

These symptoms may signal anoxia- or hypoxia-related brain damage that can lead to serious, long-term disabilities such as cerebral palsy, epilepsy, developmental delays or hearing and vision impairment. In some cases, a child might need lifelong treatment, therapy, medications and home modification.

How Are Anoxia and Hypoxia Diagnosed?

Several tests are now widely available to confirm whether a child has anoxic or hypoxic brain injury. These include the following:

• Head CT scan.
• MRI.
• Electroencephalogram.
• SPECT tests (these check various areas of the brain for metabolism and blood flow).
• Evoked potential tests that evaluate visual, auditory and sensory pathways).

How Are Anoxia and Hypoxia Treated?

The most commonly prescribed treatment modality for these conditions is neonatal hypothermia, also known as cooling therapy. By lowering the brain’s temperature, damage can be minimized. Furthermore, cells can begin to recover and heal. Additionally, babies who stopped breathing for up to five minutes are often placed on ventilators.

What is the Prognosis for Babies with Anoxia or Hypoxia at Birth?

The answer to this question depends on the severity of the brain damage and the existence of other health conditions. Babies who have suffered HIE are more likely to have severe brain damage as well as permanent disabilities including cerebral palsy. This may lead to the need for lifelong care, therapies, surgeries, medications or modifications.

How Does Medical Negligence Relate to Anoxia and Hypoxia at Birth?

It is the responsibility of the medical team to monitor the health of the mother throughout pregnancy, labor and delivery. In many cases, complications such as anoxia and hypoxia can be totally avoided if providers quickly recognize the signs of fetal distress and act immediately. If a provider fails to pick up on these symptoms or does not act appropriately in accordance with accepted medical standards, they may be held liable for any injuries or disabilities suffered by the baby as well as related costs.

Labor and delivery are complicated and risky processes. Some outcomes cannot be foreseen and are out of everyone’s control. That being said, providers are expected to diligently diagnose, manage and treat medical conditions and must unfailingly communicate with a mother and her family at every juncture about what is happening and what to expect.

If you believe that medical negligence may have led to your child’s injury or disability, time is of the essence. When you consult with a legal team with expertise in birth injury, you can learn if you may be entitled to compensation for your baby’s anoxia or hypoxia at birth. You and your family deserve justice, so don’t wait another day to get the legal help you deserve.