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Austin Medical Malpractice Blog

What to watch for during a forceps delivery

Babies who are delivered with the assistance of forceps may experience minor injuries. Typically, these injuries involve bruises or marks around the head, and a baby could be scratched by the device as well. Mothers in Texas and elsewhere could also be injured if forceps are needed to complete a delivery. While most injuries heal over time, this is not always true.

For instance, if a baby is scratched, it could leave him or her vulnerable to infection. If a mother has HIV, the baby could be at risk of contracting it through an open wound. Mothers can also experience infection if the walls of the bladder or rectum are penetrated during a forceps delivery. Incontinence could be a side effect that mothers face after a delivery involving forceps.

What is meconium aspiration sydrome?

Birth injuries cause permanent disabilities in Texas and in other states every year. Meconium aspiration syndrome, or MAS, is a breathing problem experienced by newborns that can lead to a blocked airway and permanent lung damage in some cases.

MAS is suspected when there is no other known cause for breathing problems and a baby may have passed meconium, or stool, into amniotic fluid during labor or delivery. Occasionally, a baby may aspirate on meconium while still in the uterus.

Hypoxic-ischemic encephalitis often caused by birth trauma

Hypoxic-ischemic encephalitis (HIE) is a type of brain trauma that is found in infants in Texas and across the nation. It occurs when the baby's brain doesn't receive enough blood or oxygen, and this usually happens before or during labor. The condition occurs in 20 infants out of every 1,000 live births. HIE is more likely in premature infants; approximately 60 percent of infants born before 37 weeks gestation experience HIE.

The condition affects large portions of the infant's brain and body. When HIE occurs, the supply of oxygen going to the brain is reduced (hypoxia) and the blood flow going to other vital body organs is slowed (ischemia). Symptoms of HIE typically include low heart rate, no breathing or weak breathing, amniotic fluid that contains meconium, poor muscle tone, blueish or pale skin, seizures and high levels of acid in the blood. If HIE is suspected, a doctor may order tests to confirm the diagnosis. These tests include CT scans, echocardiography, MRI scans and ultrasounds.

Birth injuries often caused by medical choices

When mothers give birth in Texas, the last thing they may expect is for themselves or their child to emerge with a serious birth injury. However, in far too many cases, medical negligence or mistakes can lead to dangerous outcomes for newborns. Despite advances in scientific knowledge, birth injury continues to pose a serious threat. For example, the rate of brachial plexus birth injury (BPBI) has increased.

Researchers have attempted to identify risk factors in order to reduce the threat of this type of birth injury by studying mothers who delivered a child with BPBI and those who did not. Medical decisions were shown to be linked to the likelihood of a negative outcome; for example, the risk of BPBI was 2.5 times greater when oxytocin was used to stimulate contractions. In addition, the risk rose 3.7 times when a condition of excessive contractions, called tachysystole, occurred during labor and delivery. Other issues were also linked to a higher BPBI risk, including greater weight gain during pregnancy and longer labor times.

Babies with brain injuries may later develop epilepsy

Injuries during birth can lead to significant medical difficulties later in life for many children in Texas. When newborn babies have acute symptomatic seizures, they could develop epilepsy later on. There are a number of reasons why newborns might have seizures, but brain injury during birth is one prominent contributor. However, it is not always clear which factors may be more likely to lead to epilepsy.

Researchers reviewed the medical records of newborns who had been admitted to the hospital between 2008 and 2014 with acute seizures. They sought to identify which babies were more likely to develop epilepsy by examining demographic data, seizure causes, medication use and the results of magnetic resonance imaging (MRI) scans. At one university hospital in San Francisco, the scientists found 144 relevant patients, 87 of whom had follow-up data available one year later. Out of those 87 babies, eight children were later diagnosed with epilepsy. The median onset age was 4.9 years. There was no clear connection between epilepsy and premature birth or the use of antiseizure medicines at hospital discharge once the results were adjusted.

Some cases of Erb's Palsy are preventable

Erb's Palsy, a form of brachial plexus palsy, occurs in one or two of every thousand births. The brachial plexus is a network of nerves near the neck that link to the nerves of the arm and shoulder. Fortunately for Texas families, most instances of this condition are relatively minor. The child quickly recovers the ability to feel and move the arm, and physical therapy allows the damaged nerves to heal.

However, there are four types of nerve injuries that may result. A shock is the minor one and most common, but there may also be stretching, rupturing or tearing of the nerves. The three more serious injuries typically result in some degree of permanent injury. As all four types of injury have similar symptoms of loss of feeling and partial or complete paralysis, it is essential to get a proper diagnosis of the severity of the injury.

Congress requests answers about childbirth safety in hospitals

In July, USA Today released results from an investigation that showed thousands of women throughout Texas and the rest of the country have died or been injured during childbirth due to lax safety practices in hospitals. As a result of the study, representatives from Congress have requested that operators from various maternity wards across the nation explain what they are doing to improve safety for mothers. The health care systems targeted were chosen for their size.

The Ways and Means Committee in the U.S. House of Representatives sent out thousands of letters. in early October seeking information about childbirth safety protocols. Committee members are attempting to answer a series of important questions, including how at-risk mothers are identified and how pregnancy-related deaths are tracked. The deadline for response by hospitals is Nov. 15.

Maternal mortality a risk for American women

Despite the fact that the United States is a global leader in health care, mothers in Texas and across the country may not receive sufficient protections during labor and childbirth. As a result, serious birth injuries can have lifelong effects on both mother and child. According to one study, mothers in the United States have the most dangerous experience in the developed world when going through childbirth. Each year, around 700 mothers die and 500,000 women suffer serious injuries during or after the birthing process.

The report notes that at least 50 percent of the deaths could have been prevented had mothers received better care in the hospital. In addition, half of the birth injuries studied could have been prevented or at least mitigated with more responsive, aware health care. Around the world, maternal mortality and injury rates have decreased, especially in other developed nations like France, Japan and Germany. However, the United States has moved in the opposite direction. Mothers face an escalating risk of death during childbirth.

Insufficient oxygen and other causes of infant brain damage

Infant brain damage frequently occurs during the delivery process, but it can also happen during pregnancy or after birth. 

Lack of oxygen may be the cause of infant brain damage, but other issues are equally critical. With proper medical care, however, infant brain damage may often be prevented.

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