Hypoxic-Ischemic Encephalopathy(HIE): Hypoxic-ischemic encephalopathy, also known as HIE, is a type of brain injury that is caused by a lack of oxygen to the brain. Hypoxic-ischemic encephalopathy is an extremely dangerous condition that requires immediate medical attention. In some circumstances, cooling therapy may be necessary following birth in order to reverse the effects of oxygen deprivation.
Cerebral palsy is caused by brain damage and the most common way that brain damage occurs while a baby is being born is through deprived of oxygen. The most common types of oxygen deprivation are referred to as the hypoxic-ischemic encephalopathy or HIE. Hypoxic-ischemic encephalopathy is also known as intrapartum asphyxia. This kind of oxygen deprivation occurs during labour and delivery.
In some instances, HIE can lead to cerebral palsy or other associated disabilities in children. Birth asphyxia cause approximately 840,000 neonatal deaths globally. Cerebral palsy is one of the most serious and costly neurological disabilities (2 out of every 1,000 births according to the U.S. National Library of Medicine National Institutes of Health) and its persistence over the child’s lifetime. The degree of disability differs by individual and is deeply dependent on how longspun the baby was lacking oxygen. Approximately one out of ten cases of cerebral palsy, of any severity, is induced by HIE. Your baby may be diagnosed with HIE at birth, and if so, you want to know what your treatment options are. There are some approaches that can be utilized to minimize the damage to your child.
According to the Florida Neonatal Neurologic Network, HIE strikes nearly 20 out of every 1,000 full-term births. The prevalence is 60 out of every 1,000 in babies born prematurely.
Causes of Hypoxic-Ischemic Encephalopathy(HIE)
The straightforward underlying cause of HIE is asphyxia. While oxygen is deprived of a significant period of time, there will occur some degree of brain damage. There are a number of various causes of HIE, What makes the asphyxia is more confused and may not be determined for every infant. Several problems or medical complications may probable causes during pregnancy in the antepartum period include:
- Medical negligence.
- Maternal diabetes with vascular disease.
- Problems with blood circulation to the placenta.
- Congenital infections of the fetus.
- Cardiac disease.
- Severe fetal anaemia
- Drug and alcohol abuse.
- Lung malformations
HIE can also affect infants during labour and delivery, known as the intrapartum period. Common intrapartum complications may include:
- Very low maternal blood pressure.
- Excessive bleeding from the placenta.
- Umbilical cord accidents.
- Abnormal fetal position.
- Prolonged late stages of labour.
- Rupture of the placenta or the uterus.
The infants can undergo the effects of HIE in the postpartum period. Premature babies are especially at risk of suffering from brain injury or even death if HIE transpires after delivery. The most usual causes of postpartum HIE include:
- Infections, including sepsis and meningitis.
- Severe cardiac or pulmonary disease
- Severe prematurity.
- Brain or skull trauma.
- Low neonatal blood pressure.
- Congenital brain malformations.
Symptoms of Hypoxic-Ischemic Encephalopathy(HIE)
The mildest instances of HIE may go with symptoms undetected and usually resolve within 24 hours. Mild HIE may be defined by poor feeding, extreme crying, irritation, or somewhat increased muscle tone in the infant. Further moderate HIE may induce lethargy, slow or absent reflexes, significantly low muscle tone, and even seizures. Babies with moderate HIE can overcome or may end up with entirely mild disabilities.
Severe HIE ordinarily commences to lasting disabilities and more severe disabilities. Newborns with severe HIE may encounter many of the above manifestations, but the seizures may not happen right away. While they do occur, seizures are inclined to be worse and to resist normal treatment. Other manifestations of severe hypoxic-ischemic encephalopathy include dilated pupils, irregular breathing, absent infant reflexes, no reaction to stimuli, irregular heart rate, and blood pressure, and coma.
Diagnosis of Hypoxic-Ischemic Encephalopathy(HIE)
If your newborn shows any signs of HIE after being born, or if there had been any kind of complication or trauma throughout the delivery that may have caused HIE, there are tests to validate HIE, after symptoms become been assessed, include CT scan, MRI scan, ultrasound, and echocardiography. Optional examinations may include an electroencephalogram (EEG), electrocardiogram (EKG), and evoked potential tests. Usually, patients are assessed on whether they become mild, moderate, or severe symptoms of HIE and the condition is managed from there.
Physicians additionally look at the pH of a sample of umbilical cord artery blood. If it is fewer than seven, this supports a diagnosis of HIE. The physicians will also consider the infant’s Apgar score. This is a quick test that is performed just a few minutes after an infant is born to evaluate the baby’s heart rate, skin colour, reflexes, muscle tone, and breathing. The healthier the baby, the bigger the score is. An Apgar score of three or less is also accepted as supporting evidence for HIE.
Treating Hypoxic Ischemic Encephalopathy(HIE)
There are various treatment options available for babies born with HIE, such as mechanical ventilation that assists with a baby’s breathing, cooling therapy to reverse brain hypoxia, hyperbaric oxygen treatment, and various medications to assist the baby’s heart function and control blood pressure.
Depending on certain criteria, cooling therapy or hypothermia has been shown to reduce death and disability in many cases. The cooling treatment is the most widely known around the world. Cooling therapy can be done on the whole body, or through a cooling cap placed on the head. The baby may also need other medical intervention such as adequate ventilation, possibly using a respirator to support breathing, maintaining certain blood pressure, managing fluids, managing blood sugar levels or to treat seizures as they recover.
Hypothermia can be employed to drop the baby’s temperature and check the amount of lasting injury to the brain. Researches have shown that babies that have experienced moderate to severe HIE and that undergo this hypothermia treatment produce better outcomes. It is believed that the cold temperatures reduce the death of brain cells and limit the formation of toxic substances in the brain that induces damage. For this cooling treatment, the newborn is cooled to about 33 degrees Celsius for 72 hours.
Preventing Hypoxic Ischemic Encephalopathy(HIE)
Hypothermia treatment has been shown to be a useful way to check the lasting damage and long-term limitations that babies born with HIE occurrence. Nevertheless, there is no cure for HIE and any baby may suffer disability because of it, regardless of the treatment method. The greatest way to avoid it is to limit the damage in the first place. Physicians and parents can work mutually to ensure safe labour and delivery. Regular checkups for the mom to maintain her health, observing the fetus during labour and delivery, and having trained and experienced healthcare practitioners on hand all help to limit the kinds of difficulties that can lead to HIE.
HIE can commence to serious consequences for a child and the family. Severe brain damage can commence to lifelong limitations that limit a child’s quality of life and that may create stress, financial quandaries, and other problems for a family. If your child sickened because of HIE during labour and delivery, you must know your rights. Advocate for your child to be diagnosed and managed as quickly as possible and to find out if someone’s negligence committed to your child’s brain damage. Discuss with a birth injury lawyer or legal organization that can help you understand what you and your child’s rights are, and what steps you require to take next to best provide for your baby.