Many birth injuries are treatable. Often, the speed with which a birth injury is identified and treatment initiated can have a significant impact on the infant’s long-term prognosis. The importance of early intervention in these cases is therefore difficult to overstate. Depending on the circumstances, identifying a birth injury and initiating an effective treatment protocol promptly can substantially mitigate, and in some cases even prevent, significant long-term adverse consequences. To learn more, or to discuss your concerns about delayed medical intervention for your child’s birth injury, consider speaking with an experienced birth injury lawyer and patient advocate at Erin Marshall Law. Reach our Albuquerque office today by calling 505-218-9949.
Birth Injuries in Which Early Intervention May Improve Outcomes
As with almost any medical condition, a birth injury will need to be identified before treatment can be initiated, so performing critical assessments in the first few hours of an infant’s life can be critical to identifying potential issues and addressing them promptly. Generally speaking, the medical preference is to start treatment as early as possible, but the importance of early intervention may be greater with some conditions than with others.
Some birth injuries that may benefit from early diagnosis and treatment include:
- Hypoxic-ischemic encephalopathy (HIE)
- Intracranial hemorrhage
- Injuries to the Brachial Plexus
- Congenital infections
The precise treatment will depend upon the type and severity of the birth injury, but in many cases early intervention can help prevent secondary injuries or additional damage.
Intracranial Hemorrhage
Intracranial hemorrhages are sometimes called “brain bleeds” because they involve bleeding inside (”intra”) the skull, in the delicate tissue of the brain. Intracranial hemorrhaging can be caused by many different types of head injuries – but, in newborns, it is often attributable to some form of birth trauma. Identifying the brain bleed early makes it possible to assess the severity of the situation and develop an appropriate treatment plan. Early intervention can help to limit brain damage, reducing the extent and severity of permanent neurological impairment and improving the infant’s chances for a long, full, and happy life.
Brachial Plexus Injuries
As Johns Hopkins Medicine (JHM) explains, the brachial plexus is a “network of nerves” responsible for carrying signals from the spinal cord to the arms and hands. Individuals are born with a brachial plexus on each side of the body, which then governs the motor control in the associated arm and hand. “Brachial plexus injury” can cover an array of symptoms that may vary, depending on the extent of damage to the nerves and the precise type of damage involved.
Prognosis for Brachial Plexus Injuries
JHM notes that, although the affected arm and hand will be where the symptoms of damage to the brachial plexus manifest, brachial plexus injuries are typically caused by some form of trauma to the neck area. The recovery outlook for individuals with relatively minor damage to these nerves is strong, with many patients regaining 90% or more of the normal function in the affected side. More serious cases, however, may require intricate surgery to repair the damage and facilitate the recovery of function.
The importance of early intervention in brachial plexus injuries among newborns lies mainly in determining whether surgery is necessary (and if so, performing the surgery as soon as possible so that the infant can begin developing appropriate motor control in the affected side of their body), and in implementing physical therapy. With or without surgery, physical therapy within the first few weeks of life can help to facilitate healing in the delicate nerves and preserve sensation in the affected arm and hand, as well as range of motion and the development of dexterity.
Challenges in Addressing Neonatal Brachial Plexus Injuries
The challenge with brachial plexus injuries resulting from birth trauma often lies in assessing the potential for brachial plexus injury in a newborn can be difficult – since, unlike adults or even older children, newborns will not have much motor control to speak of, and cannot communicate clearly regarding the type and location of their pain. Parents who are concerned about the possibility of brachial plexus injury should watch for signs of weakness or unresponsiveness in one arm or hand, particularly if the child experienced shoulder dystocia (according to StatPearls, a birth injury that occurs when an infant’s shoulder becomes “stuck” on the mother’s pubic or sacral bones during a vaginal birth).
Hypoxic-Ischemic Encephalopathy
HIE refers to a medical emergency in which the supply of blood and oxygen to the brain is constricted or stopped entirely. Once the brain is deprived of oxygen, cellular damage rapidly sets in; according to the Cleveland Clinic, appreciable brain damage begins within four minutes of cerebral hypoxia (insufficient oxygen to the brain), regardless of cause.
Although there are medical treatments and therapeutic interventions that can help individuals cope with the effects of brain damage caused by hypoxia (analogous to the therapies often implemented during recovery from a stroke), the cellular damage itself is irreversible. The severity and extent of brain damage in hypoxic-ischemic encephalopathy are directly correlated with the length of time before the brain’s blood and oxygen supply (bear in mind that oxygen is usually supplied to tissues via blood as it circulates throughout the body), so the timeframe for intervention in cases of HIE is one of the tightest, and most critical, in neonatal care. If you are concerned that a medical team’s delay in taking action contributed to the severity of your child’s outcomes from HIE, you may wish to consider speaking with a patient advocate at Erin Marshall Law to review your case.
Congenital Infections
There is some room for debate over whether a congenital infection is properly described as a birth injury, but the potential for adverse health consequences, and the importance of early intervention, remain broadly the same as with damage sustained through birth trauma. The term “congenital infections” may confuse some people who are used to seeing “congenital” used in the context of diseases that are hereditary. Unlike many other conditions described as “congenital,” a congenital infection is not genetic, but rather derives from a pathogen to which an infant is exposed either in utero or during delivery.
Congenital Infections Acquired in Utero vs. During Delivery
During pregnancy, the mother’s placenta plays an important role in protecting an infant in the womb from many, though by no means all, infections; those infections that do make it through the umbilical cord to the developing fetus can cause a variety of issues, depending on the stage of fetal development and the specific pathogen involved. During delivery, the child may be exposed to a different variety of pathogens, typically dominated by the category known as “STIs” (sexually transmitted infections) due to the frequency with which infections in this category are spread via sexual contact. Passage through the birth canal during delivery exposes an infant to many of the same tissues that would also be exposed during sexual activity, and thus presents a risk of transmission for similar reasons – with the caveat that a newborn’s immune system is not yet fully developed, and a baby may be susceptible to different types of damage from those that might be expected for an adult who acquired the same kind of infection.
Congenital Infections of Concern
The Herpes Simplex Virus (HSV) and cytomegalovirus (CMV) are among the more common viral congenital infections, with CMV being notable for its transmissibility in utero (while the baby is still in the womb), during childbirth, and even via breastfeeding in the first weeks to months of life, according to the Mayo Clinic. Bacterial infections can also pose a risk to infant health, with the Centers for Disease Control and Prevention (CDC) noting that congenital syphilis is a particularly serious concern, both because its consequences can be severe and because congenital syphilis rates have been rising rapidly in the past few years. Early intervention, usually involving a 10-day course of antibiotics administered in a hospital, can help to prevent long-term complications from syphilis infections in newborns.
Speak With a Birth Injury Lawyer
When a child’s entry into the world is marred by a birth injury, early intervention can often prove crucial in mitigating the damage and improving the child’s long-term prognosis. The importance of early intervention can vary, depending on the type and severity of the birth injury, but as a general rule sooner is typically better, and medical professionals have a responsibility to uphold the standard of care in performing timely diagnostics and developing appropriate treatment strategies tailored to each patient’s individual condition – a responsibility that can only be heightened when the patient in question is an infant, who is totally reliant on his or her parents and medical team to make the decisions that may easily affect the rest of his or her life. If your child suffered a birth injury and you have concerns about delays in the initiation of medical interventions, you may wish to consult with a birth injury advocate. New Mexico residents can reach the legal team at Erin Marshall Law by calling 505-218-9949 today.
