There are a number of birth injury types. Sometimes birth injuries are temporary, and other times they are permanent, lasting a lifetime. Symptoms often vary from one infant to another. Whereas one infant may have mild symptoms, the same injury may happen to a different infant and cause severe symptoms.
Sometimes children aren’t aware of their birth injury until they’re enrolled in school. Other times the symptoms for certain birth injuries are obvious immediately. The severity of symptoms and signs will greatly depend upon each child’s individual circumstances as well as the type of birth injury.
Brain-related birth injuries can manifest in several different ways. Often, brain injuries develop from oxygen deprivation, such as anoxia, hypoxia, birth asphyxia, and perinatal asphyxia. Hypoxic ischemic encephalopathy (HIE) is a birth injury resulting from oxygen deprivation.
When a brain has been deprived from oxygen, it can react in various ways, such as:
- Brain ischemia occurs when the brain is deprived of oxygen and nutrients.
- Brain hemorrhage occurs when blood vessels leak into the brain.
- Electrical responses are what happens when the brain reacts to oxygen deprivation, and can impair multiple brain functions. A few common examples include seizures, and cerebral palsy.
Additionally, brain-related injuries can happen from other birth injuries such as the growth of newborn jaundice into kernicterus, flooding the brain with bilirubin, and the development of the group B strep infection to meningitis which interferes with electrical communications between the spine and the brain.
The leading brain-related injury in relation to birth trauma is cerebral palsy (CP). CP is estimated to affect around 800,000 children, with 8,000-10,000 new cases diagnosed each year. CP can develop after maternal infections, oxygen deprivation, infant stroke, and infant infection. In many instances, CP could have been eliminated with the corrective preventative measures by physician. For example, if a physician fails to monitor fetal distress and take the appropriate actions, the infant may develop CP. Other instances include:
- Failure to monitor, detect, and treat maternal infections
- Failure to plan and carry out an emergency C-section
- Failure to identify and treat a prolapsed umbilical cord
- Failure to use birth-assisting tools correctly
Muscle-Related or Physical Injuries
Cerebral palsy is often misinterpreted as a muscle-related birth injury because in some cases, the infant has total loss of muscle control. However, cerebral palsy is a brain-related birth injury that affects the way the brain sends communication to the muscle groups.
Muscle-related injuries, however, are generally easy to diagnose as a clinical evaluation can pinpoint where the limited movement or paralysis is coming from. Some muscle-related injuries may be related to more blatant medical malpractice such as lacerations, bruises, or broken bones. This can also cause other physical birth injuries such as skull fractures or cephalohematoma, the bruising of the area between the brain and the outer layers of skin.
Common muscle-related and physical injuries include:
Brachial plexus happens when the upper extremity of the arm is injured, usually during delivery. Symptoms include weakness in the affected arm and the inability to use certain muscles in the affected arm. The shoulder and hands may also be affected. Electrical-type shocks and a burning sensation down the affected arm is also common.
Erb’s palsy is a form of brachial plexus marked by the nerves of the upper arm being affected, usually after a birth injury. Infants with Erb’s palsy may experience the loss of feeling and weakness in the affected. In severe cases, infants may have total paralysis in the affected arm.
Klumpke’s palsy, another form of brachial plexus, is caused by damage to the lower nerves in the arm, affecting the arm, wrists, and fingers. Typically, an infant with Klumpke’s palsy with have total paralysis in the affected area, and the hand usually takes on a permanent, claw-like shape.
Shoulder dystocia is a complication of labor and delivery that occurs when an infant’s head and shoulders get trapped behind the mother’s pelvic bone during delivery. Although shoulder dystocia only happens in 1% of all pregnancies, the complications that arise with this type of injury can be severe. Along with the risk of maternal hemorrhaging and uterine rupture, the baby may experience difficulties when breathing, a collarbone fracture, cerebral palsy, a brachial plexus fracture, and in some instances, death.
Birth Injuries Related to Infections or Developed Through Pregnancy
Sometimes the responsibility of who passes on the birth injury is fuzzy. In some instances, a birth injury is passed on from the mother, though a physician’s job is to detect and treat any maternal problems. A couple of these injuries are attributed to infections, such as the group B strep infection or meningitis, both infections that the mother can carry in the vagina without even knowing it (about 1 in every 4 mothers carry these infections without any symptoms or knowledge of these infections). Children can catch this from their mothers just by being born, by passing through the birth canal where these infections are stored.
Other birth injuries caught from the mother are injuries developed through pregnancy that the physician should have tested for or found early. These injuries include folic acid deficiency, anemia, and spina bifida. These birth injuries could have possibly been prevented by the mother taking supplements based on the physicians recommendations.
Additional, a birth injury that could happen at the end of pregnancy just before delivery is meconium aspiration syndrome, which occurs when the infant is under stress from a long and difficult delivery. The infant defecates in the uterus and then breathes in the meconium, causing severe breathing problems after birth.
Injuries from Delivery
Birth injuries that arise during delivery is a common occurrence. These types of injuries occur from the use of vacuum extractor or forceps, tools invented to assist in delivery. Other injuries from delivery may include administering the wrong medication, mishandling the infant, resulting in broken bones, lacerations, or skull fractures. Depending on how the physician handles the delivery, an infant may also experience injuries related to stress, high blood pressure, or hypertension.
Persistent Pulmonary Hypertension of the Newborn (PPHN)
Persistent pulmonary hypertension of the newborn (PPHN) occurs when fetal circulation does not transition to life outside the womb. Throughout pregnancy, the placenta provides oxygen to the fetus. After birth, however, the newborn must learn to breathe on his or her own. If this transition is unsuccessful, then the newborn may be suffering from PPHN.
PPHN is often the result of a difficult birth, yet in many instances it arises due to medical negligence. For example, prescription-based medications such as Zoloft, Celexa, and Paxil have been linked to an increase in blood pressure and during pregnancy this can place stress on the infant. Other causes include failure to treat maternal infections, failure to detect and prevent infant asphyxia, and performing an unnecessary C-section.