HIE, or hypoxic ischemic encephalopathy, is a type of birth injury. It is caused by birth asphyxia, or oxygen deprivation (lack of oxygen) This type of injury can occur during pregnancy, during labour and delivery, or after a baby is born.
There are many potential causes of HIE, such as preeclampsia, trauma during the birthing process, excessive contractions, and low blood pressure after birth. Proper medical care and interventions, including cooling therapy in the hours after birth, can help to reduce swelling in the brain and avoid the brain damage from spreading.
At BILA, we advocate for parents and families whose children have suffered preventable birth injuries. Reach out to us to learn more about how we can help if your baby was diagnosed with a brain injury caused by medical negligence.
What Is Hypoxic Ischemic Encephalopathy?
Hypoxic Ischemic Encephalopathy, or HIE, is a type of brain dysfunction that occurs when the brain is deprived of oxygen or blood flow for a period of time. This lack of oxygen is known as birth asphyxia, while HIE is the resulting injury to the brain. HIE’s name can be broken down as follows: hypoxic means insufficient oxygen, ischemic means not enough blood flow, and encephalopathy means a brain disorder.
HIE is commonly associated with birth injuries, although it can develop during pregnancy, labour and delivery, or after a baby is born. As discussed in greater detail below, there are a number of possible causes of HIE.
Some children who have been diagnosed with HIE will experience only mild or moderate effects. Other children – particularly those who suffered from oxygen deprivation for a longer period of time – may have more serious outcomes from HIE, such as a developmental delay, cerebral palsy, epilepsy, and/or cognitive impairment.
During the first year of HIE, parents should watch for signs that their child is missing developmental milestones. Typically, the signs and symptoms of HIE become more obvious as a baby gets older. However, a child may not be diagnosed with hypoxic ischemic encephalopathy until they reach school age.
What Causes HIE?
While hypoxic ischemic encephalopathy is often referred to as a birth injury, it does not exclusively happen during labour and delivery. It can occur during pregnancy, during the birth process, or after birth (postnatal).
Causes of HIE During Pregnancy
Neonatal encephalopathy may occur during pregnancy if a fetus is deprived of oxygen for a period of time. This may be caused by:
- Problems with blood flow to the placenta (which is an organ that develops during pregnancy for the purpose of delivering oxygen and nutrients to the fetus);
- Heart disease
- Maternal substance use disorder
- Preeclampsia, or maternal high blood pressure
- Issues with lung formation
- Congenital infections
- Low blood count (anemia) in the fetus
- Maternal diabetes with vascular disease
While HIE during pregnancy cannot always be prevented, proper prenatal care can often spot potential risk factors for fetal distress so that they can be treated appropriately before a hypoxic-ischemic injury occurs.
Causes of HIE During Labour and Delivery
When there is a problem during the birthing process, it may cause oxygen deprivation to the brain. In many cases, birth asphyxia is a sign of medical negligence. Potential causes of HIE during labour and delivery include:
- Placental abruption
- Placental insufficiency
- Placenta previa
- Rupture of the uterus
- Bleeding from the placenta
- Umbilical cord problems, such as nuchal cord, prolapsed cord, or compressed cord
- Very low maternal blood pressure
- Prolonged late stages of labour (delayed delivery)
- Tachysystole, or excessively frequent uterine contractions
- Abnormal fetal position, such as breech position
- Trauma to the baby’s brain during delivery
- Elevated fetal heart resting tone between contractions
If your baby suffered oxygen or blood flow deprivation during birth, then it may result in a low Apgar score. In this situation, cooling therapy (or therapeutic hypothermia) should be used to allow the baby’s brain to recover and prevent the spread and severity of brain damage.
Causes of HIE During the Postnatal Period
HIE may also occur after a baby is born due to a lack of oxygen. Perinatal asphyxia is associated with brain injuries and related disabilities, including cerebral palsy. Causes of neonatal encephalopathy after birth include:
- Severe lung or heart disease
- Low blood pressure in the baby
- Respiratory failure or cardiac arrest
- Serious infections
- Trauma to the brain or skull
- Severe prematurity
If a baby shows signs of neonatal hypoxic-ischemic encephalopathy, they should receive prompt medical care, including cooling therapy and support for the heart and lungs. Other treatments, such as medication for seizures, may also be necessary.
How BILA Can Help
Brain injuries due to poor blood or oxygen supply before, during, or after birth can cause serious, long-term complications. In some cases, this type of birth injury can also lead to permanent disabilities. While HIE isn’t always preventable, proper medical care during all stages of pregnancy, labour and delivery and after birth can help to avoid or mitigate the effects of oxygen deprivation.
The Birth Injury Lawyers Alliance (BILA) works with families throughout Canada whose child has suffered a birth injury due to HIE and other causes. We will advocate for you and your child, working to get you the compensation that you need to support your child and your family. To learn more or to schedule a free initial consultation with an HIE lawyer in your province, call BILA today at 1-800-300-BILA or fill out our online contact form.
