Recent updates to guidelines issued by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics advise physicians to conduct extensive examinations on babies born with brain injuries, or neonatal encephalopathy. According to a report on the Health Day website, the two groups have determined that, by pinpointing the causes of brain injury, physicians can prevent further complications and create new techniques for prevention. The previous recommendations were presented in 2003, directing doctors to place their focus on the possible lack of oxygen to the brain during delivery. The new guidelines are extending those recommendations to include other details of the delivery, as well as the mother's physical condition.
Loss of oxygen is reportedly a common cause of newborn brain injury, but the causes can begin before labor even starts. According to the report, there are several possible causes for these injuries:
Researchers hope that the new guidelines will result in treatment advances for prevention and management of brain injuries in newborns. Currently, treatment is utilized at much higher rate than prevention. According to a National Institute of Health report, the current treatment model includes:
Correction of hypertension
Management of pulmonary disturbances
Maintenance of glucose levels
Treatment of seizures
Monitoring for additional organ system complications
Neonatal hypothermia is reportedly the sole method of prevention currently in common use. The article explains that the treatment cools a newborn's body down for 72 hours. This suppresses the cell pathways, which defers the death of healthy cells and minimizes long-term damage to the brain.
The Frequency and Complications of Neonatal Encephalopathy
According to the Health Day website, physicians are reacting positively to the recommendations, with one doctor referring to the guidelines as a “safety document.” The guidelines call for a more proactive approach by pediatricians as well. The report states that more than 3,000 American hospitals perform births on a daily basis. Out of that number, neonatal intensive care units are only available in about 1,000 of them. Researchers state that in the other 2,000 facilities, pediatricians should be actively involved in treating newborns with brain related birth injuries or quickly referring them to a facility where neonatal hypothermia is offered.
The NIH reports that neonatal encephalopathy occurs in one to five of every 1000 live births. Of those occurrences, 15% to 20% of the babies do not survive the postnatal period and about 25% are diagnosed with various childhood disabilities. The levels of damage to the brain affect the extent of injury in the baby. Severe encephalopathy in newborns can result in death. Survivors are at a significant risk of cerebral palsy and mental retardation. Moderate encephalopathy can result in “memory impairment, visual motor or visual perceptive dysfunction, increased hyperactivity, and delayed school readiness.”
These recommendations give doctors a higher level of responsibility and accountability for newborns with birth injuries to the brain. Failure to follow this suggested course of action for detection and prevention of neonatal encephalopathy could result in legal liability.
If you are the parent of a baby who was born with an injury to the brain, contact the attorneys of Levin & Perconti.
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