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Diagnosis of Birth Injuries

Diagnosing Injuries During Labor and Delivery

There are many birth injuries that can occur during labor and delivery, including hypoxic-ischemic encephalopathy (HIE), cerebral palsy, Erb’s palsy, bone fractures, and kernicterus (from untreated jaundice). These are conditions that can have immediate as well as long-term consequences. Early diagnosis and proper treatment are key to helping the child recover, but some newborns do not receive timely care. Failure to diagnose and delays in treatment are forms of medical malpractice that have an adverse effect on the victim's lifespan and quality of life.

Early Testing and Diagnosis

It is the responsibility of doctors and other medical professionals to recognize symptoms of birth injuries and to respond accordingly. Many birth injuries are treatable if they are diagnosed and treated early. However, there are cases where medical professionals do not identify the symptoms of an injury and fail to order the necessary tests or treatment. In other cases, the injuries do not manifest right away and the young victims are not diagnosed in a timely manner. This can affect their prognosis and have an impact on the types of treatments that are available.

Monitoring the Baby’s Health During the Birthing Process

Labor and delivery are stressful for the child as well as for the mother. During a contraction, the baby is squeezed tightly in the mother’s uterus, which interrupts the blood supply from the placenta to the baby. It is crucial for doctors and midwives to monitor the baby’s heartbeat during labor for signs of fetal distress. If the infant is distressed, the doctor may need to perform a C-section to prevent serious injuries.

During labor, fetal heart rate monitoring can be performed in several ways:

Electronic Fetal Monitoring (EFM) or Continuous monitoring: This type of monitoring usually happens during labor and delivery and may be necessary with certain health conditions or events, including:

  • High blood pressure, pre-eclampsia, or diabetes;
  • BMI of 40 or higher;
  • Previous C-section;
  • High maternal temperature;
  • Fresh bleeding from vagina during labor;
  • Water broke before the start of labor and more than 24 hours have passed;
  • Mother is delivering twins;
  • Child is smaller than expected;
  • Waters contain significant amounts of meconium;
  • Prolonged labor in first or second stage;
  • Oxytocin is administered to speed up labor; or
  • Epidural is administered during labor.

Intermittent monitoring: The infant’s heart rate is monitored with a hand-held Doppler fetal monitor (Sonicaid) or ear trumpet (Pinard stethoscope). During active labor, a healthcare provider should listen to the baby’s heartbeat for at least one minute every 15 minutes after a contraction. At the pushing stage, this should be performed every five minutes.

Fetal scalp electrode: After the mother’s water has broken, a small clip known as a fetal scalp electrode can be placed on the baby’s head to monitor fetal heart rate. It can provide a more accurate reading on its own, or in conjunction with intermittent or continuous monitoring.

A doctor may also take a fetal blood sample to better monitor the child’s condition during labor. The baby’s head is sprayed with a local anesthetic, and then the doctor passes a rod with a small blade through the vagina to take a small amount of the infant’s blood. The blood is analyzed for oxygen content. If the blood sample contains insufficient oxygen, the doctor should take another sample in approximately half an hour. If oxygen levels are low and the child is in distress, an emergency C-section delivery may be necessary to prevent injury to the baby.

Failure to monitor the baby during the birth process can result in serious birth injuries or death of the child. Failure to recognize signs of distress or take action when they occur can be equally harmful. A healthcare provider can be held liable for failure to:

  • Monitor vital signs during pregnancy and the birth process;
  • Monitor for complications with the umbilical cord; or
  • Correctly interpret signs of fetal distress.

If your child has been injured because the doctor, nurses or hospital did not perform the necessary tests, or did not correctly interpret test results and take timely and effective action to prevent injury, your best course of action is to speak with a knowledgeable birth injury attorney. You may be eligible to file a claim for compensation for your losses.

Diagnosing Different Birth Injuries

Here are a few common birth injuries and their symptoms.

Head trauma and brain injury: Babies may suffer head injuries during a difficult labor and delivery. Head injury or brain injury can result from labor that requires the use of forceps or a vacuum extractor. Babies can suffer skull fractures or hemorrhages (bleeding) subgaleal hemorrhages (bleeding between the scalp and skull) and cephalohematoma (hemorrhage below the scalp and above the outer surface of the cranium). Immediately after delivery, the doctor must check to see if the newborn's head is swollen, discolored, or misshapen.

Cerebral palsy: Cerebral palsy can result from injuries suffered during labor and delivery. If a baby does not get enough oxygen during labor and deliver, the baby may suffer an injury to his brain which can result in physical and neurological abnormalities.

Erb's palsy: A difficult childbirth can result in damage to the nerves that travel from the neck to the hands. Doctors should know if the baby's head and neck were pulled as the shoulders passed through the birth canal, and order the necessary tests. It is also possible that the newborn suffered a bone fracture or is experiencing severe weakness in his or her arm.

Meconium aspiration syndrome: One of the leading causes of death and severe illness among babies occurs when the newborn breathes a mixture of amniotic fluid and stool into the lungs at the time of delivery.

What Is an Apgar Score?

The Apgar score is a method used by doctors and nurses to assess the status of a newborn baby. The Apgar score is comprised of five components that are assessed by the medical provider after birth: heart rate, respiratory effort, muscle tone, reflex irritability, and color, each of which is given a score of 0, 1, or 2. Apgar scores are assessed at one and five minutes after birth.

Low Apgar scores may indicate recent hypoxic-ischemic insult to the baby. The one-minute Apgar score may be used to identify a baby who requires special medical attention or resuscitation. The five-minute Apgar score, including the change in the score between one and five minutes, is a measure of the effectiveness of resuscitation efforts.

Seek Help from a Birth Injury Lawyer Right Away

If you have been sent home after the birth, you may assume that your baby is healthy. However, if you notice that something is not right, you should seek medical attention right away. If your baby appears to be in pain, has difficulty eating, or is slow to reach important developmental milestones, it may be in your best interest to see a doctor.

If your child suffered a birth injury that was preventable, your baby may be entitled to recover the financial costs of medical expenses, hospitalization, surgery, rehabilitation, etc. Failing to diagnose birth injuries is a form of medical malpractice. Experienced birth injury lawyer Laura Brown and Birth Injury Safety have seen first-hand the emotional and financial distress these types of injuries cause not only the young victims, but also their families. Caring for a child after a catastrophic birth injury can be a tremendous financial burden. Please contact us at (214) 974-4121 for a no-cost, no-obligation consultation.

What Is an Apgar Score?

The Apgar score is a method used by doctors and nurses to assess the status of a newborn baby. The Apgar score is comprised of five components: heart rate, respiratory effort, muscle tone, reflex irritability, and color, each of which is given a score of 0, 1, or 2. Apgar scores are assessed at one and five minutes after birth. Low Apgar scores may indicate recent hypoxic-ischemic insult to the baby. The one-minute Apgar score may be used to identify a baby who requires special medical attention or resuscitation. The five-minute Apgar score, including the change in the score between one and five minutes, is a measure of the effectiveness of resuscitation efforts.

Call Birth Injury Safety

When a child has suffered an injury related to prenatal care, labor, or delivery, it is understandable for the parents to have questions about the injury, their legal rights, and the legal rights of the child. We welcome the opportunity to talk with you about what has happened to your child and about your legal rights. Consultations are free - there is no obligation, so call and talk with one of our birth injury attorneys at (214) 974-4121. Contact us to see if we can help you.

Additional Information


Birth Injury Case Results

Gross Settlement/Verdict: $5,800,000.00

Injury: Oxygen Deprivation During Labor & Delivery Resulting in Brain Damage & Cerebral Palsy

  • A contingent (%) fee charged on the successful recovery resulted in a fee of $1,441,584 and $33,666.12 in litigation expenses which were reimbursed by the client out of the gross settlement amount.

Gross Settlement/Verdict: $3,250,000.00

Injury: Oxygen Deprivation During Labor & Delivery Resulting in Brain Injury & Cerebral Palsy

  • A contingent (%) fee charged on the successful recovery resulted in a fee of $1,300,000 and $81,511.14 in litigation expenses which were reimbursed by the client out of the gross settlement amount.

Gross Settlement/Verdict: $1,450,000.00

Injury: Oxygen Deprivation During Labor & Delivery Resulting in Brain Injury & Cerebral Palsy

  • A contingent (%) fee charged on the successful recovery resulted in a fee of $558,000 and $26,618.00 in litigation expenses which were reimbursed by the client out of the gross settlement amount.

>> View all Case Results

Note: If any of the cases listed here had been unsuccessful, the law firm would have paid all of the expenses for the case without being reimbursed by the client and would have received $0 dollars in attorney's fees.

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Birth Injury Safety
Saint Paul Place, Suite 1660A,
750 N. Saint Paul Street, Dallas Texas 75201

Phone: (214) 974-4121
Email: brown@trialfirm.com

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