Cerebral Palsy

CEREBRAL PALSY
BY John Bonina and Andrea Bonina

Cerebral Palsy is a permanent brain injury that can cause problems controlling muscles, walking, using one’s arms and legs, or decreased mental functioning.

When a child is diagnosed with cerebral palsy parents often ask “Why did this happen to my child?”.

Although there are many factors that can cause cerebral palsy, one of the most prominent factors is medical negligence during the childbirth process.

Recognizing Risk

During the labor and delivery process, many complications can occur, so it is imperative that the physician or midwife attending to the mother watch for signs of fetal distress and respond quickly and appropriately. Many brain injuries are the result of avoidable errors during the labor and delivery process.

There are many causes of fetal distress and brain injury. Some of the more common causes are when the baby’s head is too big to fit through the mother’s pelvis (sometimes called cephalo-pelvic disproportion), or if the umbilical cord becomes wrapped around the baby’s neck (prolapse).

If a doctor presses forward with a vaginal delivery in the face of cephalo-pelvic disproportion, this can cause a squeezing or crushing injury to the child’s brain. Doctors can and should be aware when the baby is too big to fit through the mother’s pelvis, especially when there is a big baby, a slow progress of labor, or fetal distress.

If the umbilical cord becomes wrapped around the baby’s neck, this can be a very dangerous situation. The blood supply to the baby can get cut off as the umbilical cord gets kinked. Once again, signs of fetal distress on the fetal heart monitor can alert the doctor so that a Cesarean Section can be performed to save the baby. If a C-Section is not done, the blood supply gets more and more reduced the further the child passes down the birth canal, often resulting in brain injury due to lack of oxygen.

A baby in distress will often exhibit warning signs. Fetal distress can cause the heartbeat of a baby to drop, and can cause the baby to have a bowel movement in the amniotic fluid, which is called meconium. If meconium is present when the mother’s water breaks it may have a greenish appearance.

The presence of meconium in the amniotic fluid when the mother’s water breaks can be considered an indicator of fetal distress. It is a factor that the doctor or midwife should consider in determining the need for a cesarean section to avoid risk of brain damage.

A brain injury can occur during birth as a result of meconium aspiration. This occurs when the baby inhales the fetal bowel movement prior to delivery, resulting in a loss of oxygen to the brain. This is one of the reasons that meconium in the amniotic fluid should be a warning sign to a doctor or midwife delivering a baby.

One way doctors watch for fetal distress is on fetal monitor strips. Fetal distress should indicate to the doctor that the baby is having a problem.

Fetal monitoring and correct interpretation of the fetal monitor strips is extremely useful in identifying risk to a baby and permitting doctors to intervene before a birth injury, such as cerebral palsy, occurs.

When there are patterns that indicate that the baby is in distress, the doctor or midwife should investigate the need for a C-Section. Often the mother will be turned on to her left side and possibly given oxygen. If that does not help, a scalp Ph test should be performed to determine if the baby is becoming acidotic as a result of lack of oxygen. If the Ph level indicates acidosis, a C-section must be performed.

If a C-Section is not performed in a timely fashion, the brain can become deprived of oxygen and injured. This can happen as the result of a number of factors, including aspiration of meconium, deprivation of oxygen, reduced blood flow to the brain, failure to do a timely cesarian section, failure to respond to signs of fetal distress soon enough, or the failure to deliver the infant when the membranes had been ruptured for an extensive period of time.

When medical errors such as these occur, it can cause devastating injury to a baby by depriving the brain of oxygen during labor and delivery. This deprivation of oxygen can cause cerebral palsy.

Signs of Injury

Immediately after birth indicators that the newborn has been injured include the baby being born blue, or requiring resuscitation shortly after birth.

Molding, or a cone like shape to the newborn’s head, may indicate that the newborn was in the birth canal for too long or that the head was too big for the birth canal. The development of seizures shortly after birth is also an indicator of a brain injury.

The severity of a brain damage depends on the location of the injury in the brain and when the injury occurred. The longer a child goes without oxygen, the greater the injury to the brain will be.

Signs of cerebral palsy that may alert parents and doctors to a problem in the first few months of life include irritability or fussiness, lack of alertness, trembling in the arms and legs, poor feeding, low muscle tone, seizures, abnormal reflexes, or favoring one side of the body. Although an injured infant’s muscle tone may be floppy at first, over time they may develop high tone, or extreme stiffness. This can result in the infant’s hands being fisted or uneven movement causing one side to move in a jerky fashion. Infants with cerebral palsy are slow to reach developmental milestones such as rolling over, sitting up, and walking, talking and grabbing.

Long Term Effects

Children and adults with cerebral palsy can require ongoing medical care to deal with the physical problems caused by this brain injury. As cerebral palsy is a permanent injury, the expenses of physical therapy, occupational therapy, medications and potential surgeries will span the injured person’s lifetime.

To learn more about cerebral palsy please visit the links section of our website. If you or a family member has a child who has sustained a cerebral palsy injury and wish to discuss your legal rights, please feel free to
call us toll free at 1-888- JOBLAW 1.