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Austin Medical Malpractice Blog

Periventricular leukomalacia: what it is

Expectant mothers in Texas should be aware of the most common type of brain injury that occurs among premature infants: periventricular leukomalacia. It is a condition where the periventricular white matter, located around the sides and top of the brain, is damaged.

The damage leads to cell death and the building up of fluid in those areas where the dead cells have broken down. These cells are supposed to control various physical and mental actions, and the connection that the white matter has to both brain and spinal cord allows the body to move smoothly. PVL can result in mental and physical impairment, including language disabilities, hearing disorders, strabismus and spasticity.

Birth injuries mothers may suffer

When you think about birth injuries, you probably think immediately of a newborn. In Texas, the occurrence of newborn injuries during labor and delivery continues at a steady pace.

However, what about the mother? The focus is almost always on the baby, but mothers can also suffer traumatic and devastating injuries during labor and, more commonly, delivery. Take a look at some of the injuries women sustain while giving birth and the contributing risk factors.

Mixed cerebral palsy: symptoms and treatments

There are various types of cerebral palsy, including spastic, athetoid and ataxic CP. However, residents of Texas should be aware that some patients exhibit symptoms that are common to all of these types, in which case they have what medical specialists call mixed cerebral palsy. Approximately 10% of CP patients have this condition.

It's clear that cerebral palsy is mixed when it's a combination of at least two types of CP. Most cases of mixed CP are a combination of spastic and athetoid CP whereas the least common combine ataxic and athetoid CP. Spastic CP is characterized by muscle stiffness, and athetoid CP usually manifests itself in involuntary movements, including jerking, twisting and slow writhing. Mixed CP patients may also experience difficulty speaking and swallowing, especially when agitated.

Birth injuries could put infants' lives at risk

Many Texas parents-to-be are concerned about the potential for serious health problems for their babies. While infant mortality rates have declined nationwide, 22,335 babies lose their lives each year. Parents are worried their children might suffer serious injuries during birth that can be fatal or life-changing. There are certain factors that are the most common causes of infant mortality. Prenatal complications and birth and labor injuries are some of the more frequent contributors to babies' deaths, as are infectious diseases, birth defects, auto accidents and homicide.

The U.S. has a significantly higher infant mortality rate than other developed countries and ranks 33rd out of 36 wealthy nations that are members of the Organization for Economic Cooperation and Development. Congenital birth defects and other problems that arose during pregnancy cause almost half of all infant deaths, mostly associated with premature birth and low weight at birth. Multiple babies like twins and triplets are particularly at risk. There is a serious racial disparity associated with infant mortality, and black, Native American and Latino parents are much more likely than white parents to lose a child.

Meconium aspiration syndrome: symptoms and treatments

Meconium aspiration syndrome is a birth injury that expecting mothers in Texas and around the country should know about. Meconium is the stool that infants pass before they start to feed on milk or formula. Usually, infants pass meconium after birth. Problems with the placenta or umbilical cord, though, can cause infants to pass meconium while in the uterus due to the stress caused by lower blood and oxygen supply.

When infants breathe this feces into their lungs (aspiration) while in the uterus, during delivery, or after birth, they may develop MAS. It is characterized by breathing problems and sometimes even periods of apnea. Rapid or noisy breathing are other symptoms. Infants may even develop cyanosis, or a bluish tint to their skin.

3 birth injuries that may prove fatal

Childbirth is natural, but that does not make it easy. Until a few decades ago, childbirth was the number one killer of women.

Advances in healthcare have changed this statistic, but it does not mean accidents do not still occur. Doctor decisions made in the days and hours leading up to birth may impact the path a delivery takes. Expectant parents must pay attention to the signs indicative of birth trauma. The following three birth injuries can lead to lifelong health challenges for a child and possibly even premature death.

Fetal distress, asphyxiation need separate terms

In the past, Texas newborns who experienced fetal problems or asphyxia were often grouped together under the generic term "fetal distress." However, this term does not give an accurate description of what the baby may be experiencing. The Committee on Obstetric Practice of the American Congress of Obstetricians and Gynecologists (ACOG) is recommending that the term fetal distress get replaced with non-reassuring fetal status.

Fetal distress is often used when a fetus is not receiving a sufficient amount of oxygen while in the womb or during labor. This is typically indicated by the use of a heart rate monitor. Fetal asphyxia is similarly defined as a baby who doesn't receive adequate oxygen before, during or after labor. It can have multiple causes such as a knot in the baby's umbilical cord, umbilical cord compression or lack of oxygen in the mother's blood.

Overview of persistent pulmonary hypertension babies

Babies born at 34 weeks or more run the risk of developing a breathing condition called persistent pulmonary hypertension at birth. Before babies are born, they receive oxygen from their mother, and most of this oxygen does not reach the lungs because the blood vessels are closed. Once a newborn takes the first few breaths, the blood vessels open. Mothers in Texas should know that with PPHN, the blood vessels do not open entirely.

This leads to a lack of oxygen being carried by the blood to the brain and organs. Symptoms of PPHN include rapid or slow breathing and low blood pressure. One may notice that the baby's skin is somewhat blue and that the hands and feet are cool to the touch. PPHN can be treated through the use of a ventilator or a heart-lung machine. It can take weeks or months for the baby to recover.

Klumpke paralysis birth injury often responds to timely treatment

Difficult births in Texas occasionally result in birth injuries, like Klumpke paralysis. This paralysis limits an infant's ability to use the affected shoulder and arm. Damage to the nerves of the brachial plexus that happen during birth cause the partial paralysis. In some cases, a baby might have a drooping eye as well. Most infants have a chance of regaining most function if they receive appropriate treatment.

The severity of the injury determines the course of treatment. Stretch injuries of the nerves usually heal after the infant's arm has been immobilized for 7 to 10 days. Massage and range-of-motion exercises also provide useful therapies. Babies with stretch injuries typically recover in four to six months. Nerves that experience tears and ruptures generally need surgery to repair the damage. Surgeons sometimes must transfer tendons to the injury site to rebuild the necessary tissue connections. Without surgery, the infant cannot hope to regain function.

Shoulder release surgery could help Erb's palsy patients

All Texas parents want their baby to be born healthy. Unfortunately, there are several injuries that an infant can suffer during the birthing process. One of those injuries is brachial plexus birth palsy, which is also known as Erb's palsy.

Erb's palsy occurs when certain nerves in a baby's neck are damaged as he or she passes through the birth canal, causing weakness or paralysis in the shoulder, arm and hand. Some children eventually recover from the injury, but others are left with a permanent arm disability. However, according to a new study, a surgical treatment called isolated open anterior shoulder release can improve arm function in some Erb's palsy patients.

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