Articles Posted in Brain Damage

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According to a recent lawsuit filed in the U.S. District Court of Tennessee, defendant health care providers failed to properly handle the delivery of the minor plaintiff, resulting in extended fetal oxygen deprivation and brain injury at birth. Specifically, the complaint alleges that during the mother’s labor and delivery, medical personnel failed recognize and respond to clear signs of declining fetal response, indicating the need for an emergency C-section.

The mother plaintiff gave birth to her first child via Cesarean section, and shortly thereafter she became pregnant again. According to the lawsuit, despite her risk factors, including short stature; previously unsuccessful attempt at vaginal birth; and a brief time between the two pregnancies; the mother plaintiff was advised that she was a good candidate for a vaginal birth after C-section (VBAC).

The mother plaintiff went into labor early, and within the first half hour the EFM strip indicated minimal variability and loss of accelerations (two signs of fetal compromise). According to the lawsuit, rather than being admitted to the Labor & Delivery ward, the fetal monitoring was stopped and the mother plaintiff was advised to walk around the hospital for an hour or so. About two hours later, she was admitted whereupon labor progression was slow and the fetal monitoring continued to show repetitive late decelerations. After several hours, a C-section delivery was ordered.

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Cerebral palsy is a term used to cover a group of brain and nervous system disorders affecting 10,000 babies annually. About 50% of all cerebral palsy cases involve full-term or near full-term infants. According to the American Medical Association, there are ways to prevent cerebral palsy in full-term and premature infants.

One way to prevent CP in a full-term infant is to prevent chorioamnionitis. Chorioamnionitis is an inflammation or infection in the amnion and/or chorion, the membranes that surround and protect a fetus before birth. It affects 1-10% of term births and is often associated with prolonged labor.

Risk factors for chorioamnionitis include: prolonged labor, maternal age (less than 21 years old), prolonged rupture of membranes, first pregnancy, and multiple vaginal examinations during labor. If it is timely diagnosed (typically after a mother exhibits a fever, increased heart rate, uterine tenderness and/or foul smelling amniotic fluid), chorioamnionitis can be treated with intravenous antibiotics (usually ampicillin or clindamycin, plus gentamicin). Undiagnosed chorioamnionitis, which may be the result of medical malpractice, can lead to serious complications including bacteremia, meningitis and respiratory distress syndrome which, depending upon the severity, can restrict fetal oxygenation and lead to cerebral palsy.

In preterm infants, administering a drug called magnesium sulfate 24 hours before delivery may also reduce the risk of cerebral palsy. Studies suggest that “mag sulfate” has a neuroprotective effect.
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