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Austin Medical Malpractice Blog

Periventricular leukomalacia, an infant brain injury

In Texas and across the U.S., many infants born prematurely suffer a brain injury called periventricular leukomalacia, or PVL. The ventricles, or fluid-filled areas, of the brain are fragile before 32 weeks of gestation, and changes to blood flow in these areas can easily lead to PVL. Infection during delivery is another possible cause of PVL.

PVL is a form of brain damage where parts of the brain tissue surrounding the ventricles die and create "holes" in the brain. As a consequence, the baby may experience developmental delays, usually around the first and second years of life. The condition may also lead to cerebral palsy, especially muscle tightness and spasticity in the leg muscles.

An overview of jaundice in newborns

Jaundice occurs when the blood has high levels of bilirubin, a yellow substance created from the replacement of old red blood cells. In a baby, the placenta breaks down bilirubin before the liver takes over, but liver development may be slow. Therefore, it's not unusual for infants to be born with high bilirubin levels and develop jaundice. Expectant mothers in Texas may want to know more.

Jaundice will yellow a baby's skin and the whites of the eyes. This yellowing may spread to the chest, stomach area and legs. In severe cases of jaundice, babies may feed poorly and always be tired. Most babies, however, experience what is called physiological jaundice. It's most noticeable two to four days after birth, usually does no harm and goes away within a couple of weeks.

Doctors must recognize blood-type issues to avoid birth injuries

Texans who are expecting a child will be excited about the future. As they take the necessary steps to plan for the birth, they are placing significant trust in the medical professionals caring for the expectant mother and unborn baby. Unfortunately, this trust can be misplaced and errors can happen. In some cases, these errors result in birth injuries that can have a lasting impact on the child’s life. Testing procedures must be followed. If they are not and something goes wrong, medical professionals should be held accountable.

One commonly worrisome issue is Rhesus incompatibility. Rhesus (Rh) protein factors are a key part of understanding if health problems can happen. If there is a difference between the mother and the unborn child's Rh, it is incompatible. If the baby is found to be Rh-negative, it means there is an absence of that protein.

Surgical errors that can happen during a C-section

Cesarean sections are a prevalent form of birth in the U.S. According to the CDC, 32% of all births in 2017 were C-sections. Texas alone had a rate of 35%, coming in at number eight in the nation. While C-sections can be necessary and life-saving in certain situations, they can be more harmful than helpful when there is no true medical need for the procedure. These preventable C-sections are called "unnecesareans."

Even those that are essential still come with the risk of injury and complications, just like with any other surgery. 

Shoulder dystocia and its effect on birth trauma

While in labor, some Texas mothers may experience a condition known as shoulder dystocia. This condition is a type of birth trauma that occurs when the baby's shoulders become stuck inside the mother's pelvis during delivery. It could cause problems for both the mother and child, which is why it is important to identify it right away.

Some women are more susceptible than others to shoulder dystocia. For example, ladies with gestational diabetes have a higher risk. Women who have previously delivered children with birth injuries, including those related to shoulder dystocia, are at a higher risk too.Likewise, moms carrying larger children who weigh over 8 pounds are more likely to encounter should dystocia during labor and delivery.

An overview of cephalohematoma

Expectant mothers in Texas should know about a condition called cephalohematoma, which can develop if too much pressure is placed on the baby's head during delivery. Such trauma, even when minor, can rupture the small blood vessels in the baby's head and cause blood to pool (hematoma) underneath the scalp. The pooling is gradual, so cephalohematoma is usually detected hours or days after birth.

The pressure may be caused by a difficult delivery, or the doctors may exert it by using forceps or vacuum extractors. Various factors raise the risk for cephalohematoma, including fetal macrosomia (babies who are larger than normal), weak uterine contractions and abnormal fetal presentation, such as the occipital posterior or transverse occipital position. Male babies are more likely to suffer from the condition, but the reason for this is unclear.

Birth trauma may lead to facial nerve palsy in infants

Infants who are born during a traumatic birth in Texas may experience facial nerve palsy as a result. Facial nerve palsy is a condition that causes the loss of the voluntary muscles in the infant's face. In an estimated 88% of cases of facial nerve palsy, the cause is due to birth trauma.

The symptoms of facial nerve palsy include the infant not being able to completely close his or her eye on the affected side, the infant's lips not moving the same while crying, the infant's lower face being uneven under the eyes or having no discernible movement on the affected side of the face. The condition is typically diagnosed with a physical exam although it is sometimes necessary to complete a nerve conduction test to pinpoint the exact location of the injured nerve.

Caps on medical malpractice awards in Texas

Medical mistakes are the third most common cause of death in Texas and around the country. Some medical malpractice victims who survive require around-the-clock medical care for life, which is why the damages awarded in these cases are often high. Many states, including Texas, have passed laws that limit the amount of compensation that can be awarded in medical malpractice cases, but these laws sometimes only apply to non-economic damages.

A medical malpractice case highlighting these issues was recently decided in Maryland. A jury awarded the mother of a 4-year-old girl who suffered birth injuries $229.6 million in damages. The damages were high because the girl will never be able to walk, needs constant care and receives her nourishment through a feeding tube. The mother successfully argued that her daughter's injuries could have been avoided if the hospital involved had urged her to undergo a caesarian section.

All about kernicterus

A newborn infant can have many health complications that lead to long-lasting effects on the child. Most problems, however, are treatable if physicians detect and diagnose the issues fast enough.

Kernicterus is a serious condition that can occur when physicians fail to treat jaundice in a newborn. Kernicterus may stem from medical malpractice if the physician reasonably should have diagnosed and treated the jaundice sooner.

Forceps delivery may injure the baby and the mother

The use of forceps during delivery can result in injuries both to the baby and to the mother. Texas residents should know that while most of the injuries are minor, others can be serious. The minor injuries include bruising and scratches around the baby's face and head. On the other hand, a deep cut may lead to infection. If the mother is HIV-positive, the baby will risk contracting the infection.

The pressure of the forceps may damage the facial nerve, causing facial paralysis. This paralysis is usually temporary and mild, but there are cases when it may necessitate surgery and remain a permanent disability.

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