Halifax Birth Injury Attorneys
The birth of a new baby is supposed to be a joyful occasion. Unfortunately, it can quickly turn tragic if your baby is injured because of the actions of a negligent healthcare provider.
Babies can suffer serious injuries during labour and delivery that can affect them for the rest of their lives. If your baby has suffered a birth injury, it’s important to seek legal representation from an experienced birth injury lawyer immediately! The birth injury lawyers at McKiggan Hebert are committed to helping you fight for the compensation you deserve. Call 902-423-2050 or fill out the form on this website now to schedule a free consultation regarding your case.
What Are the Most Common Types of Birth Injuries?
Babies can suffer a number of different types of birth injuries as a result of negligent healthcare providers, including:
- Cerebral palsy;
- Hypoxic Ischemic Encephalopathy (HIE), also known as Birth Asphyxia;
- Brain injury;
- Jaundice or Kernicterus;
- Facial paralysis;
- Periventricular Leukomalacia;
- Brachial plexus injuries;
- Fractures;
- Hypoglycemia; and
- Hemorrhages.
Cerebral palsy is one of the most severe injuries that can occur during a child’s birth. This condition affects a child’s posture, movement, and balance skills. It’s the most common motor disability in children, and those who suffer from this condition may need special equipment to walk for the rest of their lives. Some people will not be able to walk at all even with special equipment.
Cerebral palsy is typically not diagnosed until the child is between 1 to 2 years old. This is the period where the symptoms of cerebral palsy become obvious to parents and physicians.
Is Cerebral Palsy Always Caused By Medical Malpractice?
While CP isn’t always caused by medical malpractice, one of the major causes of cerebral palsy (CP) in children is medical negligence during labour and delivery. This typically involves preventable errors or inadequate care during pregnancy, labour, delivery, or shortly after birth.
There are several ways in which medical negligence can lead to an injury that causes cerebral palsy in your child:
- Failure to Monitor Fetal Distress: In every labour and delivery the healthcare professionals looking after the mother and baby are required to monitor the mother and baby’s wellbeing. This is commonly done by tracking the fetal heart rate to look for patterns that indicate possible distress. If the doctors and nurses looking after the mother during labour do not adequately monitor the baby’s heart rate and other vital signs during labour, they may miss signs of fetal distress. Prolonged fetal distress can lead to oxygen deprivation (hypoxia) or brain damage, resulting in cerebral palsy.
- Delayed or Improperly Managed Delivery: Another common cause of cerebral palsy in children are delays in performing a necessary cesarean section (C-section). This can result in prolonged labour and increased risk of birth asphyxia (lack of oxygen to the baby’s brain), which can cause cerebral palsy.
- Misuse of Delivery Instruments: In some deliveries the doctors must use instruments to help deliver the baby. The improper use of forceps or vacuum extractors during delivery can lead to physical trauma to the skull which can cause brain injuries, which in turn can result in cerebral palsy.
- Failure to Treat Infections: Infections in the mother, such as uterine infections, or in the baby, such as meningitis, need prompt and adequate treatment. Chorioamnionitis, also known as intra-amniotic infection, is a severe condition impacting individuals during pregnancy. It derives its name from the chorion and amnion, the two membranes encompassing the fetus in the uterus. This type of infection arises when bacteria infiltrate any of the tissues or membranes surrounding the fetus. Untreated or poorly managed infections can lead to brain damage and cerebral palsy.
- Inadequate Postnatal Care: Newborns with jaundice, respiratory issues, or other conditions that could lead to brain damage need appropriate and timely medical intervention. Failure to provide adequate care can result in conditions like kernicterus, which can cause cerebral palsy.
- Improper Management of Premature Birth: Premature infants are at higher risk for complications that can lead to cerebral palsy. Failure to provide proper prenatal care to prevent premature birth or failure to manage a preterm baby’s health adequately can result in a type of brain injury called Periventricular Leukomalacia or PVL.
If you suspect your child’s cerebral palsy may have been caused by medical negligence, you need to contact a birth injury lawyer to conduct a thorough investigation. This will typically involve a review of the facts surrounding the labour a delivery, an examination of all the medical records, and consultation with medical experts like obstetricians, pediatric neuroradiologists, neonatal specialists, and pediatric neurologists to establish that the standard of care was not met, and that this failure directly resulted in an injury that caused your child’s condition.
What kind of medical mistakes can lead to Cerebral Palsy?
Mistakes made during labour and delivery can cause CP. For example, doctors and nurses need to act quickly when the baby is exhibiting signs of distress during labour. If a doctor or nurse fails to take action, the baby may lose oxygen, which can cause a brain injury leading to cerebral palsy.
A negligent doctor can also cause cerebral palsy after the baby is born by failing to diagnose and treat jaundice or other serious conditions.
Many cases of cerebral palsy are caused by negligent doctors and nurses. However, there are certain factors that can increase the chance that a child will develop cerebral palsy. Doctor’s and nurses are required to be even more vigilant in these circumstances, because the fetus is especially vulnerable to injury. These circumstances include:
- Premature birth (premature birth is generally accepted to mean babies born before 37 weeks of pregnancy);
- The baby being too small at birth (this is a condition called small for gestational age, usually considered to be less than 5 pounds 8 ounces or 2500 grams);
- Having twins or multiple births; and
- The mother developing an infection while pregnant (which can cause chorioamnionitis).
These are just some of the many factors that can increase a child’s risk of developing cerebral palsy.
If your child has been diagnosed with cerebral palsy, your child may be entitled to compensation. But first, you will have to prove that your child’s cerebral palsy was caused by a healthcare professional’s negligence.
Birth injury claims are among the most complicated and expensive types of personal injury claims. Succeeding in these types of claims is not easy, which is why you should turn to the trusted medical malpractice lawyers at McKiggan Hebert for help.
Hypoxic Ischemic Encephalopathy (HIE) and the Long-Term Effects of Birth Asphyxia
What is Birth Asphyxia?
Birth asphyxia, commonly called hypoxia, happens when a baby doesn’t get enough oxygen before, during, or right after birth. The baby’s oxygen and nutrient supply come from the mother via the umbilical cord. If this flow is obstructed, it can lead to asphyxia. Hypoxia can be caused by issues like blood flow interruptions between mom and baby, circulation problems, or airway blockages. Lack of oxygen can lead to a type of brain damage called hypoxic-ischemic encephalopathy (HIE).
Risk Factors for Birth Asphyxia
Certain conditions increase the risk of birth asphyxia, such as:
- Preeclampsia/eclampsia;
- Anesthesia errors;
- Low amniotic fluid;
- Placental issues that prevent the flow of oxygen through the placenta;
- Umbilical cord problems that decrease blood flow through the cord;
- Premature birth;
- Prolonged labour; and
- Premature rupture of membranes which can lead to infection.
If your doctor or nurse fails to exercise appropriate care when these risk factors are present, it could be considered a breach of the standard of care (medical negligence).
What is Hypoxic-Ischemic Encephalopathy (HIE)?
What is ischemia?
Ischemia happens when there isn’t enough blood supply to a particular organ or tissue (in the case of HIE it is lack of blood flow to the baby’s brain). Ischemia to the brain deprives the brain of oxygen necessary for its normal function.
What causes ischemia during labour and delivery?
The causes of ischemia can vary depending on the specific circumstances during the labour and delivery. Ischemia to the fetal brain during labour and delivery is usually due to one or more of the following factors:
- Uncontrolled Uterine Contractions: Intense or prolonged uterine contractions during labour can temporarily reduce blood flow to the baby, compromising oxygen and nutrient delivery to the baby’s brain. This reduction in oxygenated blood supply can lead to ischemia in the fetal brain.
- Umbilical Cord Compression: Compression or occlusion of the umbilical cord, which serves as the lifeline between the fetus and the placenta, can disrupt blood flow to the fetus and oxygen delivery to the fetal brain. Umbilical cord compression can occur due to factors such as umbilical cord prolapse (when the cord precedes the fetus into the birth canal), cord entanglement, or excessive cord length.
- Placental Insufficiency: Conditions such as placental abruption (premature separation of the placenta from the uterine wall) or placental infarction (areas of tissue death within the placenta) can compromise its ability to adequately supply oxygen and nutrients to the fetus. This can result in fetal hypoxia (oxygen deprivation) and subsequent ischemia in the fetal brain.
- Maternal Hypotension: Problems with maternal hypotension (low blood pressure) during labour and delivery can reduce the blood flow through the placenta and umbilical cord. This results in reduced oxygen delivery to the fetus and makes the baby’s brain more vulnerable to injury due to ischemia.
- Prolonged Labour: It is not uncommon for the second stage of labour to go on for hours, sometimes may hours. But prolonged labour, particularly if it is accompanied by fetal distress or maternal exhaustion, can increase the risk of ischemia to your baby’s brain. Whenever the mother is pushing during labour, this creates pressure on the fetal head and brain. Prolonged compression of the fetal head against the maternal pelvis during several hours of second stage labour can compromise blood flow to the baby’s brain.
- Fetal Stroke or Hemorrhage: In very rare cases, fetal stroke or hemorrhage can occur during labour and delivery, leading to sudden interruption of blood flow to specific areas of the fetal brain and subsequent ischemia.
- Intrapartum Infections: Maternal infections such as chorioamnionitis (infection of the fetal membranes) or maternal fever during labor can trigger an inflammatory response that may affect fetal well-being, including blood flow to the brain.
- Medical Interventions: Sometimes the baby gets stuck during delivery and medical instruments may be used to assist the delivery. Certain medical interventions, like the use of forceps or vacuum extraction, can increase the risk of fetal head trauma or compression, potentially leading to ischemic injury to the fetal brain.
It’s essential for healthcare providers (doctors and nurses) to closely monitor fetal well-being during labour and delivery. Continuous fetal heart rate monitoring, assessment of uterine contractions, and timely intervention in cases of fetal distress can help reduce or eliminate the risk of ischemia and other adverse outcomes in the newborn.
The Impact of HIE
HIE can result in various disabilities, such as cerebral palsy, epilepsy, vision problems, learning disabilities, and developmental delays. How bad these effects are typically depends on how severe and long the oxygen deprivation lasted. If the baby did suffer HIE during delivery, immediate treatment with cooling therapy after birth can help minimize or even eliminate brain damage.
The Short-Term Effects of HIE
In the immediate aftermath of HIE, babies can experience a range of symptoms, which include:
- Neonatal Seizures: This is caused by uncontrolled electrical activity in the brain causing convulsions and is typically seen in the first few days after delivery.
- Hypotonia: Low muscle tone, resulting in a “floppy” appearance to the baby’s arms and legs.
- Organ Dysfunction: During HIE the body diverts blood flow to the brain to protect against brain injury. But this means the baby’s other organs may not be getting enough blood flow which can cause problems with the heart, liver, kidneys, and other organs.
- Poor Brain Stem Reflexes: Diminished responses in reflexes controlled by the brain stem, such as sucking, swallowing, and breathing.
- Feeding Difficulties: Problems with sucking and swallowing, making it hard for the baby to feed.
- Depressed Level of Consciousness: Reduced alertness and responsiveness, ranging from lethargy to coma.
The Long-Term Effects of HIE
If HIE causes a significant brain injury to your baby, it can lead to lifelong disabilities and developmental challenges. Some potential long-term effects include:
- Cerebral Palsy (CP): This is perhaps the most devastating injury caused by HIE. CP is a group of disorders affecting movement, muscle tone, and posture, resulting from damage to the brain before, during, or shortly after birth.
- Developmental Delays: Brain injury due to HIE can cause delays in reaching milestones such as crawling, walking, and talking.
- Learning Disabilities: Difficulties with academic skills such as reading, writing, and mathematics.
- Behavioral and Emotional Disorders: Many children who have been injured by HIE have issues such as attention deficit hyperactivity disorder (ADHD), anxiety, and depression.
- Seizure Disorders: Ongoing risk of seizures, which can vary in frequency and severity.
- Vision Impairments: Including blindness or other visual problems.
- Hearing Impairments: Ranging from mild hearing loss to complete deafness.
- Feeding and Nutritional Concerns: Problems with eating and digesting food, which may require special diets or feeding tubes.
- Orthopedic Issues: Abnormalities in bone growth and joint function, which can affect mobility and physical development.
- Respiratory Problems: Chronic lung issues and difficulties with breathing.
What Impact Does HIE Have on Families?
The long-term care for a child with HIE can be emotionally and financially devastating for families. Children with severe disabilities may require extensive medical care, physical therapy, occupational therapy, and special education services. This often involves significant costs, specialized equipment, and potential modifications to the home environment to accommodate the child’s needs.
Early Intervention and Treatment
If a doctor suspects fetal distress may be causing birth asphyxia, it is critical that the baby be delivered as soon as possible, before the fetal distress can cause permanent injury. This may require an expedited vaginal delivery using instruments like forceps or vacuum or, if there are no prospects of a safe vaginal delivery, an emergency c-section might be necessary.
Early intervention is crucial in managing HIE. Treatments like therapeutic hypothermia (cooling therapy), where the baby’s body temperature is lowered to reduce brain damage, can significantly improve fetal outcomes. Cooling therapy should be administered within six hours to reduce brain damage. This involves lowering the baby’s body temperature to 33.5°C for 72 hours to slow the metabolic rate and allow brain cells to recover.
In fact, if your baby underwent cooling therapy it mans that your doctors have diagnosed your baby as suffering from HIE. Since HIE is almost always preventable with proper care, it means that you should definitely contact a birth injury lawyer as soon as possible to investigate whether your baby’s HIE could have been avoided.
Continued medical follow-up and appropriate medical therapies can help manage symptoms of HIE and improve the child’s future quality of life.
It is important to understand that the impact of HIE varies widely based on the severity of the initial brain injury and how quickly treatment is administered. While some children may recover with minimal or no issues, others may face lifelong challenges requiring comprehensive care and support. Early diagnosis, prompt treatment, and ongoing therapy are key to mitigating the effects of HIE and improving outcomes for affected children.
Treatment for Birth Asphyxia
As we have already explained, treating birth asphyxia promptly is crucial to minimize brain damage and improve outcomes for the affected newborn. Here are the main steps and methods used to treat birth asphyxia:
Immediate Interventions
Resuscitation at Birth:
- Clear the Baby’s Airways: Suctioning the baby’s mouth and nose to clear any blockages and ensure the airway is open.
- Stimulation: Gentle rubbing to stimulate breathing if the baby isn’t breathing on their own.
- Giving Oxygen: Providing supplemental oxygen through a mask or nasal cannula to ensure adequate oxygenation to the baby.
Advanced Resuscitation:
- Positive Pressure Ventilation (PPV): This is when the doctor or nurse uses a bag and mask to help your baby breathe if spontaneous breathing doesn’t start.
- Intubation and Mechanical Ventilation: Placing a tube into the baby’s airway and using a machine to assist with breathing if PPV isn’t effective.
- Chest Compressions and Medications: Performing chest compressions and administering medications like epinephrine in severe cases to support heart function and improve oxygen delivery.
Therapeutic Hypothermia
Cooling Therapy:
- What is it? Cooling the baby’s body to around 33.5°C (92.3°F) for up to 72 hours using cooling blankets or caps.
- Why cool the baby? Lowering baby’s body temperature slows the metabolic rate, reducing the risk of further brain injury by giving brain cells time to recover.
- When must it be done? Therapeutic cooling must be started within six hours after birth to be effective.
Supportive Care
The doctors and nurses caring for your child will administer a variety of other supportive measures to treat and prevent further injury to your baby.
Monitoring and Support:
- Vital Signs: Continuous monitoring of heart rate, breathing, blood pressure, and oxygen levels.
- Blood Gases: Regular blood tests to monitor pH levels (acid-base balance) and oxygen/carbon dioxide levels.
Nutritional Support:
- IV Fluids: Providing fluids intravenously if the baby cannot feed orally.
- Tube Feeding: Using a nasogastric tube to provide nutrition if necessary.
Managing Seizures:
Anti-Seizure Medications: Administering medications like phenobarbital or midazolam to control seizures, which are common in babies with HIE.
Organ Support:
- Cardiac Care: Medications and support for heart function if there are heart-related issues.
- Renal Support: Dialysis or medications for kidney support if there are renal complications.
- Respiratory Support: Continuing ventilatory support if the baby has difficulty breathing on their own.
Long-Term Care and Follow-Up
After your child is discharged from the hospital your baby may require ongoing support from a variety of caregivers.
Neurological Assessments:
- Brain Imaging: Using MRI or ultrasound to assess the extent of brain injury.
- Developmental Evaluations: Regular check-ups to monitor the baby’s developmental milestones and identify any delays or disabilities early.
Therapies:
- Physical Therapy: To improve motor skills and muscle tone.
- Occupational Therapy: To assist with fine motor skills and daily activities.
- Speech Therapy: To address feeding issues and, later, speech and language development.
Specialist Care:
- Neurologists: For ongoing management of neurological issues.
- Cardiologists, Nephrologists, and Pulmonologists: For specialized care related to heart, kidney, or lung issues resulting from birth asphyxia.
Preventing Birth Asphyxia
Most birth asphyxia cases, and related injuries are preventable. Healthcare providers who fail to diagnose or treat conditions leading to asphyxia and HIE may be held responsible for medical negligence.
Preventing HIE (Hypoxic-Ischemic Encephalopathy)
While not all cases of HIE can be prevented, many can be avoided with proper prenatal care, proper monitoring during labour, and timely medical intervention when signs of fetal distress present themselves. Here are some key strategies for prevention:
Prenatal Care
Get Regular Check-Ups: Consistent prenatal visits help monitor the health of both mother and baby. This allows for early detection of potential issues that could lead to birth asphyxia like low birth weight, maternal infections or hypotension.
Managing Existing Health Conditions: Conditions like diabetes, hypertension, and infections should be managed promptly and effectively during pregnancy to reduce risks.
Monitoring Fetal Growth: Regular ultrasounds and other assessments ensure the baby is developing properly and that there are no issues like intrauterine growth restriction (IUGR).
Monitoring During Labour and Delivery
Fetal Monitoring: Continuous electronic fetal monitoring (EFM) tracks the baby’s heart rate and detects signs of fetal distress. Timely responses to abnormal readings can prevent oxygen deprivation.
Prompt Response to Complications: Quick action in the presence of complications like umbilical cord issues, placental abruption, or uterine rupture is crucial. This might involve an emergency cesarean section.
Avoiding Excessive Labor Stimulation: The use of labour-enhancing drugs like Pitocin or Syntocin must be carefully managed to avoid uterine hyperstimulation ( contractions that are too frequent or too strong), which can reduce blood flow to the baby.
Risk Factor Management
Preeclampsia/Eclampsia: Monitoring and managing blood pressure in pregnant women can prevent conditions like preeclampsia and eclampsia, which can lead to reduced oxygen supply to the fetus.
Amniotic Fluid Levels: Ensuring there are adequate levels of amniotic fluid helps cushion and protect the baby, maintaining proper oxygen flow.
Managing Preterm Labour: Efforts to prevent preterm labor and managing preterm births with appropriate medical care reduce the risk of HIE.
Postnatal or Neonatal Care
Immediate Assessment: Using the Apgar score to assess a newborn’s health immediately after birth helps identify babies at risk of HIE. Prompt treatment can reduce the likelihood of long-term damage.
Therapeutic Hypothermia: If HIE is suspected, cooling therapy should be administered within six hours to lower the baby’s body temperature and mitigate brain damage.
Healthcare Provider Training and Protocols
Training: It is critically important that the nurses and doctors in charge of your labour and delivery are properly trained. Ensuring that nurses and doctors are well-trained in recognizing and managing fetal distress and other complications during labor and delivery can literally mean the difference between life and death.
Standardized Protocols: It is well known in the medical community that implementing standardized protocols for managing high-risk pregnancies and labour can improve outcomes and reduce the incidence of HIE. That is why every hospital must have standard policies in place to address the various emergencies that can occur during labour and delivery.
Communication: Effective communication among the medical team during labour and delivery ensures that any signs of distress are quickly and efficiently addressed.
Legal and Advocacy Efforts
Accountability: Holding healthcare providers accountable for negligence can improve care standards and reduce preventable cases of HIE. McKiggan Hebert has received national recognition for it’s success in representing children who have been injured due to medical negligence. Our firm has achieved record breaking settlements in birth injury cases in Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland & Labrador.
Education and Advocacy: Raising awareness about the importance of prenatal and perinatal care among expectant parents and healthcare professionals can lead to better prevention strategies.
While HIE cannot always be prevented, many steps can be taken by doctors and nurses to minimize the risk. Proper prenatal care, vigilant monitoring during labour, timely medical interventions during fetal distress, and effective neonatal care are crucial in reducing the occurrence and impact of HIE. By focusing on these preventive measures, the chances of preventing birth asphyxia and subsequent brain injuries can be significantly improved.
Understanding Kernicterus: Causes, Prevention, and the Role of Medical Negligence
Kernicterus, a rare but serious condition, occurs as a result of severe jaundice in newborns. It is characterized by the accumulation of bilirubin in the brain, leading to neurological damage. In this article, we delve into the causes of kernicterus, methods of prevention, and the unfortunate instances where medical negligence may contribute to its occurrence.
What is Kernicterus?
Kernicterus stems from hyperbilirubinemia, a condition where there is an excessive build-up of bilirubin in the blood. Bilirubin, a yellow pigment produced during the breakdown of red blood cells, is usually processed by the liver, and eliminated from the body. However, in newborns, the liver may not yet be fully developed, leading to inefficient bilirubin metabolism.
When levels of bilirubin become dangerously high, it can cross the blood-brain barrier and accumulate in the brain tissues. This accumulation causes neurological damage, leading to symptoms such as poor muscle tone, lethargy, seizures, and in severe cases, permanent brain damage or death.
Causes of Kernicterus:
Several factors can contribute to the development of kernicterus in newborns:
- Prematurity: Premature infants are at higher risk due to their underdeveloped livers.
- Breastfeeding: In some cases, breastfeeding-associated jaundice can exacerbate bilirubin levels.
- Blood Type Incompatibility: ABO or Rh blood type incompatibility between the mother and the baby can increase the risk.
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency: This enzyme deficiency can lead to increased breakdown of red blood cells, resulting in higher bilirubin levels.
- Delayed Recognition and Treatment: Failure to promptly diagnose and treat jaundice can lead to its progression to kernicterus.
Prevention Strategies:
Kernicterus is referred to by doctors as a “never event”. What this means is that a child should never be injured by kernicterus, because identifying the condition is simple, and the treatment is completely effective in preventing permanent injury. So preventing kernicterus primarily revolves around the timely identification and management of jaundice in newborns.
This includes:
Monitoring Bilirubin Levels: The doctors and nurses caring for your baby should routinely assess your baby’s bilirubin levels, especially newborns at higher risk.
Phototherapy: Phototherapy involves exposing the baby’s skin to special lights that help break down excess bilirubin. This treatment is simple, and does not pose any risk to the bay. In most cases it is completely effective in treating and eliminating excess bilirubin that can cause kernicterus.
Exchange Transfusion: In severe cases, where phototherapy is ineffective, an exchange transfusion may be performed to replace the baby’s blood with donor blood, lowering bilirubin levels.
Education: Providing parents with information about the signs of jaundice and the importance of seeking medical attention promptly can aid in early detection and intervention.
Medical Negligence and Kernicterus:
Unfortunately, kernicterus is almost always caused by medical negligence. Negligence may occur if healthcare providers fail to:
Monitor Jaundice: Failure to monitor bilirubin levels or recognize the severity of jaundice can delay treatment, allowing bilirubin levels to rise to dangerous levels.
Provide Timely Treatment: Delayed initiation of phototherapy or exchange transfusion can exacerbate jaundice, increasing the risk of kernicterus.
Follow Guidelines: Healthcare providers are expected to adhere to established guidelines for the management of neonatal jaundice. Deviating from these standards of care may constitute negligence.
In cases where kernicterus is the result of medical negligence, affected families may contact a birth injury lawyer to pursue legal action to seek compensation for the harm caused to their child. Medical malpractice lawsuits can hold healthcare providers accountable for their actions and provide families with the resources needed to care for a child with lifelong disabilities.
McKiggan Hebert has successfully pursued some of the largest birth injury settlements in Atlantic Canada.
Conclusion
Kernicterus is a rare but devastating condition that can result from untreated jaundice in newborns. Timely identification and management of jaundice are crucial in preventing its progression to kernicterus. However, in cases where medical negligence contributes to its occurrence, affected families may pursue legal recourse to seek justice and support for their child’s care. Increased awareness, education, and adherence to established guidelines can help mitigate the risk of kernicterus and ensure the well-being of newborns worldwide.
Periventricular Leukomalacia (PVL): Understanding Causes, Implications, and the Role of Medical Negligence
Periventricular leukomalacia (PVL) is a significant concern in obstetrics and neonatal care, often associated with brain injury in fetuses and newborns. This article explains the potential causes of PVL, the implications of medical negligence, and the profound impact it can have on a child’s neurological development.
Understanding Periventricular Leukomalacia (PVL):
Periventricular leukomalacia refers to the softening or necrosis (death) of white matter near the cerebral ventricles in the brain. White matter plays a crucial role in transmitting signals between different parts of the brain and the body. When white matter in the brain is damaged, as it is in PVL, it can disrupt these communication pathways, leading to neurological impairments.
PVL is most commonly diagnosed in premature infants, particularly those born before 32 weeks of gestation. This is because the brain tissue of premature fetus’ are particularly vulnerable to injury. However, it can also occur in full-term infants, albeit less frequently. The exact mechanisms underlying PVL are not fully understood, but medical experts generally believe PVL is caused by factors including:
- Hypoxic-Ischemic Encephalopathy (HIE): Insufficient oxygen and blood supply to the developing brain, either in utero, during labour and delivery or during the neonatal period, can cause PVL. Factors such as placental insufficiency, maternal hypertension, or umbilical cord abnormalities can contribute to hypoxic-ischemic injury.
- Inflammatory Processes: Inflammation within the fetal brain, triggered by infections or maternal inflammatory conditions, may contribute to the development of PVL. Infections such as chorioamnionitis (inflammation of the fetal membranes) or maternal infections during pregnancy can increase the risk of inflammatory responses in the fetal brain.
- Vascular Injury: Disruption of blood flow to the periventricular white matter, either through thrombotic events or hemorrhage, can result in ischemic injury and subsequent PVL. This can occur due to maternal-fetal vascular malformations, clotting disorders, or trauma during birth.
Medical Negligence and PVL:
While some cases of PVL occur despite appropriate medical care, there are many instances where medical negligence may cause PVL. Medical negligence refers to a breach of duty of care owed to a patient by a healthcare provider, resulting in harm or injury. In the context of PVL, medical negligence may manifest in several ways, including:
- Failure to Monitor Fetal Well-Being: Inadequate monitoring of fetal well-being during pregnancy, labour, and delivery can increase the risk of hypoxic-ischemic events leading to PVL. Healthcare providers have a duty to closely monitor maternal and fetal health and intervene promptly in cases of fetal distress.
- Delay in Delivery: Failure to timely deliver a fetus in distress, such as in cases of prolonged labour or non-reassuring fetal heart rate patterns, can exacerbate hypoxic-ischemic injury and increase the risk of PVL, especially in premature babies.
- Mismanagement of Maternal Conditions: Inappropriate management of maternal conditions such as hypertension, diabetes, or infections during pregnancy can contribute to fetal hypoxic-ischemic injury and subsequent PVL.
- Inadequate Neonatal Care: Suboptimal neonatal care, including improper handling of preterm infants or failure to provide timely interventions such as respiratory support or treatment of neonatal infections, can exacerbate the risk of PVL in vulnerable newborns.
Implications of PVL and Brain Injury:
The consequences of PVL and associated brain injury can be profound, affecting the child’s neurological development and long-term functional outcomes. Depending on the extent and location of the brain damage, children with PVL may experience a range of neurological impairments, including:
- Cerebral Palsy: PVL is a leading cause of cerebral palsy, a group of motor disorders characterized by impaired muscle coordination and movement.
- Cognitive Impairments: Children with PVL may exhibit learning disabilities, developmental delays, and intellectual impairments affecting academic achievement and adaptive functioning.
- Sensorimotor Deficits: PVL can lead to sensory impairments, such as visual or auditory deficits, as well as motor deficits, including muscle weakness, spasticity, or dystonia.
- Behavioral and Emotional Challenges: Some children with PVL may experience behavioral problems, emotional dysregulation, or psychiatric disorders such as attention-deficit/hyperactivity disorder (ADHD) or anxiety.
Conclusion
Periventricular leukomalacia is a significant neurological condition that can result in lifelong challenges for affected children and their families. While PVL can occur due to various factors, including prematurity and intrauterine insults, medical negligence may exacerbate its development in some cases. Healthcare providers must adhere to established standards of care, closely monitor maternal and fetal well-being, and provide timely interventions to mitigate the risk of PVL and other adverse outcomes in neonates. Increased awareness, education, and accountability in obstetric and neonatal care are essential to safeguarding the health and well-being of newborns and reducing the incidence of preventable brain injuries like PVL.
What Are Your Legal Options If Your Child Has Suffered A Birth Injury?
There is nothing more devastating than learning that your child has cerebral palsy due to a doctor or nurse’s mistakes. If your family is in this situation, you may be able to recover compensation by filing a birth injury claim. Your family may be awarded compensation for:
- Current and future medical expenses;
- Mental and physical pain and suffering;
- Loss of income;
- Loss of future earning capacity; and
- Cost of future care.
Our cerebral palsy lawyers have years of experience helping families recover the compensation they deserve for devastating birth injuries. We have recovered some of the largest personal injury settlements in Atlantic Canada on behalf of our injured clients.
We aren’t afraid to go head-to-head with doctors, hospitals, and other healthcare defendants in order to secure the compensation your child and family needs and deserves.
Free Parent’s Guide About Birth Injury Claims
John McKiggan and Brian Hebert co-wrote the only Canadian legal education guide specifically for parents of children that have suffered a birth injury. Click on the link to get a free copy of Birth Injury Claims: A Parent’s Guide written by the members of the Birth Injury Lawyers Alliance of Canada.
Seek Legal Representation From Our Experienced Birth Injury Lawyers Today
Do you suspect your child has suffered a birth injury due to the negligence of a healthcare provider? If so, seek legal representation from the medical malpractice lawyers at McKiggan Hebert as soon as possible. Medical malpractice cases involving birth injuries are extremely complex, but our team understands what has to be done to win compensation on your behalf.
We understand that every dollar counts in a birth injury case. That’s why our Personal Injury Attorneys in Halifax will work tirelessly to ensure your family is fully compensated. Our clients have received some of the largest birth injury settlements in Atlantic Canada. We want you to obtain the compensation you need to ensure your child can live comfortably and lead a happy and productive life.
Learn more about your legal options—and how we can help you and your child recover compensation—by scheduling a free case evaluation with our team. To book your appointment, contact McKiggan Hebert today by calling 902-423-2050 or submitting your information using the form on this website.