Hypoxic-Ischemic Encephalopathy (HIE) and Uterine Rupture
Hypoxic-ischemic encephalopathy or “HIE” as it is commonly called, is a brain injury caused by lack of oxygen to the baby’s brain. During pregnancy, labor and delivery, the baby receives oxygen from the blood that flows from the mother through the placenta and umbilical cord to the baby.
Uterine rupture is a life-threatening complication that puts the lives of the mother and baby at risk. The uterus is the muscular organ inside the mother’s body that holds the baby during pregnancy. Uterine rupture is a tearing open of the uterus into the mother’s abdominal cavity. The baby may be extruded or forced out of the uterus into the abdominal cavity.
How a Ruptured Uterus Can Cause Birth Asphyxia and HIE
When the uterus ruptures, there may be significant bleeding from the mother which can cause the mother’s blood pressure to drop (called “maternal hypotension”). When the mother’s blood pressure drops, there can be major consequences to both the mother and the baby. Maternal hypotension can cause the mother to suffer from lack of oxygen because she does not get enough blood and oxygen to her brain as a result of her blood loss. The baby also suffers. When the mother’s blood pressure falls, the amount of blood and oxygen going through the uterus and the placenta to the baby is decreased or stopped. As a result, the baby doesn’t get enough oxygen to his or her brain which can result in birth asphyxia and Hypoxic-ischemic encephalopathy.
The placenta is attached to the inside wall of the uterus. The uterine rupture can also damage the placenta or cause the placenta to tear away from the uterine wall – a condition called placental abruption. When the placenta tears away, this condition also causes a disruption of the blood flow and oxygen to the baby resulting in birth asphyxia and Hypoxic-ischemic encephalopathy.
Birth asphyxia develops when there is a severe and/or prolonged lack of oxygen which produces an acid/base imbalance in the baby’s blood. The end result is that there is too much acid in the baby’s blood, a condition called acidosis. Acidosis is damaging to the baby’s brain cells and tissues and can cause severe and permanent brain damage. The name for that brain damage is hypoxic-ischemic encephalopathy. When a baby has suffered asphyxia during labor and delivery, often the first diagnosis given is hypoxic-ischemic encephalopathy or HIE. That hypoxic-ischemic brain damage can later manifest as cerebral palsy when the baby grows older.
Uterine rupture is a known cause of birth asphyxia, hypoxic-ischemic encephalopathy and cerebral palsy. Because it is known cause, identifying uterine rupture and acting quickly to protect the mother and the baby is critically important. Uterine rupture frequently requires an emergency cesarean section (c-section) delivery.
Signs of a Ruptured Uteris
Nurses and doctors should carefully monitor the baby’s heart rate on a fetal heart monitor device. The fetal heart monitor records the baby’s heart rate and the contractions of the mother’s uterus. Uterine rupture is often marked by a sudden change and drop in the baby’s heart rate – called fetal bradycardia. The baby’s heart rate drops below normal, which is a dangerous condition for the baby. The baby is signaling that he or she isn’t getting oxygen and needs help. Nurses and doctors must be prepared to deliver the baby by c-section quickly to safely deliver the baby and to control maternal hemorrhage. Hospitals should be prepared to provide emergency surgical and neonatal care for cases of uterine rupture.
Uterine Rupture, Hypoxic-Ischemic Encephalopathy (HIE) and Cerebral Palsy Cases
If you suffered a uterine rupture and your baby was diagnosed with hypoxic-ischemic encephalopathy or cerebral palsy, you should find out whether your child’s injury should have been prevented. Not every injury is preventable, but there are steps to take to find out if your child’s injury was preventable. Laura Brown is a board certified trial attorney who represents babies and their families in birth injury cases throughout the nation. She investigates cases in which parents are concerned and want to find out whether their child’s injury could have and should have been prevented. If you would like to find out, call her at (214) 463-2106 or fill out the Free Case Review form for a free consulation.