Cerebral Compression

• Traumatic Birth Injury
• Cerebral Compression

Cerebral Compression & Head Molding During Delivery

A newborn’s head is very vulnerable because the skull plates have not yet fused together. This leaves the baby particularly susceptible to any form of physical trauma during childbirth. While a certain amount of cerebral compression is normal as the baby passes through the birth canal, excessive pressure can result in decreased blood supply to the brain and lead to irreparable damage and long-term injuries such as hypoxic-ischemic encephalopathy (HIE). This pressure is often caused by the repeated sequence of excessively strong or long uterine contractions that compress the newborn’s head against the mother’s pelvis.

Other causes of excess pressure on the baby’s head can stem from complications such as uterine hyperstimulation, improper use of forceps and/or a vacuum extractor, prolonged or arrested labor, or cephalopelvic disproportion (CPD). In some cases, cerebral compression injuries may not cause any obvious visible damage.

There are situations, however, where there may be bruising or excessive head molding. Head molding is an abnormal head shape that results from excessive pressure on the baby's head during delivery. Mild cases of head molding often resolve on their own. However, the inflicted damage caused by excessive head molding can be severe enough to rupture a few blood vessels and cause bleeding beneath the skull or in the brain causing a serious brain injury.

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The birth injury attorneys at Miller Weisbrod Olesky are dedicated to providing compassionate legal support to families and their children living with a brain injury or birth injury, such as cerebral palsy.

Despite all the advancements that have been made in modern medicine, the risk of birth injuries is still present. If your child suffered harm due to a preventable cranial compression injury, our birth injury lawyers at Miller Weisbrod Olesky have extensive knowledge of the legal complexities surrounding these cases. We are dedicated to providing victims of medical malpractice and their families with compassionate support, expert guidance, and aggressive representation throughout the entire process. Let us fight for the justice and compensation you and your child deserve.

What is Cerebral Compression?

Cerebral compression is a type of injury that can happen when the baby's head is subjected to excessive pressure during labor and delivery. During labor, this pressure is often related to the mother's uterine muscles engaging in a pattern of contraction and relaxation that help push the baby through the birth canal.

As the baby passes through the birth canal, a certain amount of cerebral compression is normal. However, when there is excessive pressure on a newborn's head, it may result in irreparable brain damage from decreased blood and oxygen supply (hypoxia) in the brain.

Some obvious physical signs and symptoms of cranial compression injury may include:

• Cephalohematoma
• Bruising
• Caput succedaneum
• Head molding

Although this type of birth injury can occur without visible head trauma or obvious signs of birth asphyxia, cerebral compression can still have catastrophic consequences without external signs of damage. Some of these consequences include perinatal stroke, neonatal seizures, or intracranial hemorrhages.

During labor and delivery, physicians and other medical professionals are responsible for paying close attention to the health and well-being of the baby. Failure to diagnose and properly respond to signs of any of the above conditions with some form of medical intervention, such as an emergency C-section, could result in birth injuries and constitute medical negligence.

What is Excessive Head Molding?

The bones of a newborn baby's skull are soft and flexible, with gaps between the bony plates called cranial sutures. Two particularly large gaps are the front and back fontanelles (The space between the five major bones in a newborn baby's skull that have not yet fused together) where the corners of three or four developing are more flexible than in the skull of an adult because they need to shift around to accommodate passage through the birth canal. When a baby is born in a head-first position, excessive pressure from uterine contractions that are too strong or frequent may cause the head to mold into an oblong shape. Head molding is the term used to describe this abnormal head shape.

Pregnancy and birth-related factors that can contribute to head molding include breech birth, oligohydramnios, multiple births, Cephalopelvic Disproportion (CPD), and prolonged or arrested labor. Excessive head molding most commonly occurs when labor progress is difficult or prolonged. There are several possible causes for this, including uterine hyperstimulation, abnormal fetal position or presentation, and excessive pressure on the baby's head from forceps or vacuum extractors.

Types of Head Molding

In late pregnancy or during labor and delivery, there are various types of head molding that can result from a birth injury. Some of these include:

• Cephalohematoma: A cephalohematoma is an accumulation of blood that collects in the area between the skull and the membrane that covers the skull (the periosteum) due to broken blood vessels damaged during labor and delivery. Infant cephalohematomas are often associated with a difficult or prolonged birth or the use of birth-assisting tools like forceps or a vacuum extractor. A common sign of a cephalohematoma is a raised solid bump on the back of a baby's head that appears several hours to a day after birth. This typically harmless condition affects 1 to 2 percent of all babies born. While most cephalohematomas heal without any major medical intervention, in rare instances, they can trigger certain complications that can be potentially harmful, such as anemia, jaundice, calcification, and systemic infection (cellulitis or sepsis).


• Caput Succedaneum: A caput succedaneum is swelling (edema) in the skin and tissues surrounding the infant's skull. Sometimes, this can result in a cone-like pointed shape to the baby's head. This condition is usually caused by prolonged pressure being exerted on the infant's head from the mother's uterus or vaginal wall during delivery. The swelling in the head and scalp is often triggered by a difficult delivery, the use of forceps and/or vacuum extractors, or premature rupture of membranes (PROM). Caput succedaneum itself is harmless, and the swelling often goes away without intervention after several days; however, if bruising is involved, the infant may develop jaundice.


• Skull fractures: In some cases, an abnormal head shape may be caused by bleeding beneath the skull or even a skull fracture. A newborn's softer, more flexible skull makes it more susceptible to fracture and resulting damage to the brain. An infant skull fracture is often caused by excessive pressure from instruments like forceps and vacuum extractors that doctors use to aid in the delivery of a baby. “Ping pong” skull fractures or pond skull fractures are a type of depressed fracture that is most commonly seen in newborns and often caused by trauma during instrumental delivery or pressure during obstetric maneuvers in a difficult delivery. This type of fracture is called a "ping-pong" fracture because the size and shape of the crater-like indentation it creates resembles half a ping-pong ball. Although they rarely cause severe long-term issues, in some cases, they are associated with complications such as dural tears and hematomas.

As with cerebral compressions, some head molding is common and often benign. However, excessive head molding, even if it is not visually apparent, can increase pressure inside the baby's skull and cause brain damage. If a healthcare provider fails to monitor and address excessive molding in a newborn properly, it could lead to long-term complications such as developmental delays, seizures, cognitive impairments, and hearing and visual impairments.

3-D Images Reveal Just How Much an Infant's Head Changes Shape During Birth

In 2019, French researchers used 3-D MRI (magnetic resonance imaging) scans to study just how much a baby's head changes as it goes through the advanced stages of labor. As the baby passes through the birth canal, several sections of its skull compress and overlap, giving it a distorted appearance. Through these incredibly detailed images of the skull and brain, researchers were surprised to discover just how much the newborn's head is compressed during labor.

With all seven babies that were studied, five of the infant’s skulls returned to their pre-birth state soon after delivery and showed no noticeable signs of deformation—two of the three infants with the most noticeable changes in their skulls had to be delivered via C-section. Studies like this are a positive step towards understanding why some infants are born with birth injuries. However, in spite of this understanding, doctors and other medical professionals are responsible for providing high-quality care to expectant mothers and their newborns.

Causes of Cerebral Compression Injuries

Whenever the uterine muscles contract, less oxygen is available to the placenta and fetus. During the time the uterus rests between contractions, the oxygen being delivered to the baby returns to normal. Under normal circumstances, the fetus can tolerate increased pressure in the uterine cavity and maintain blood flow by raising the arterial pressure above the pressure outside the skull.

However, if contractions are too long, strong, or frequent, the fetus cannot tolerate these variations in oxygenation, and the excessive pressure can dangerously reduce the blood flow to and from the baby's brain. Excessively strong or frequent contractions (uterine hyperstimulation/tachysystole) are often caused by the misuse of labor-inducing medications, such as Pitocin and Cytotec. The over-administration of medications used for labor induction is just one of several possible causes of excessive cranial compression.

The following factors may also contribute to cerebral compression injuries:

• Prolonged, Arrested, or difficult labor
• Abnormal fetal position (such as occiput posterior position or OP)
• Improper use of forceps and/or vacuum extractors
• Cephalopelvic Disproportion (CPD) (a mismatch between the size of the baby's head and the mother's pelvis)
• Persistent high intrauterine pressure
• The fetal head rubbing/putting pressure on the mother's pelvis
• Uterine overcrowding due to being pregnant with twins or multiples

Doctors, nurses, and other healthcare providers are required to do everything possible to avoid putting excessive pressure on the baby's head during labor and delivery. Some appropriate measures they can take to reduce the risk of head injury and/or brain damage during labor and delivery include monitoring the baby's heart rate and oxygen levels closely, using proper techniques and equipment, and performing necessary interventions, such as a C-section, if complications arise. When a healthcare professional fails to provide a reasonable standard of care and causes injury or harm to a patient, they may be liable for medical malpractice.

What Can Be Done to Prevent Excessive Cerebral Compression?

It is the responsibility of physicians and other medical professionals to ensure labor and delivery is a safe process and that the baby does not suffer any neurological injuries as a result of cerebral compression. Doctors are extensively trained to reduce the risk of infant injury during birth by detecting, carefully monitoring, and diagnosing any potential complications or abnormalities that may arise during childbirth.

During any potentially risky situation, the physician and supporting practitioners should be prepared to take appropriate measures to avoid hypoxic, ischemic, and mechanical stresses that could lead to neurological injury whenever possible. Some examples of steps medical professionals should take to help minimize the chances of cerebral compression injury include promptly performing a C-section delivery when the situation calls for it and using delivery assistance tools correctly to avoid inflicting neonatal brain injury.

Another essential part of detecting and reducing the likelihood of injury from excessive cerebral compression is the use of a high-performance monitoring system that significantly outperforms the three-category system introduced by the American College of Obstetricians and Gynecologists called the Fetal Reserve Index (FRI). The FRI is a weighted calculation of various maternal, fetal, and obstetrical risk factors that enables medical professionals to provide immediate intervention and prevent the need for emergency operative deliveries.

Common Types of Birth Injuries Caused by Cerebral Compression

There are many types of serious birth injuries that can occur during labor and delivery. Birth injuries that result from damage to the baby's head or developing brain before, during, or after birth are some of the most common. A cranial compression injury, which can also be described as head compression or head trauma, is one type of injury that can happen when excessive pressure on the baby's head during childbirth causes blood vessels to collapse, decreasing blood flow to the brain.

Some examples of newborn brain damage caused by birth-related injuries include:

• Hypoxic-ischemic encephalopathy (HIE)
• Periventricular leukomalacia (PVL)
• Hydrocephalus
• Intraventricular hemorrhage (IVH)
• Newborn cephalohematoma
• Cerebral palsy (CP)
• Cerebral dysgenesis

When a healthcare provider fails to provide a reasonable standard of care, it can result in birth injuries caused by cerebral compressions. These injuries can have a life-long impact on the affected child and their family. In addition to the physical and cognitive impairments a child who suffers from a birth injury will face, the ongoing medical treatments, therapy, and specialized care they may require can quickly become costly and place a significant financial burden on families. Recovering compensation through a medical malpractice lawsuit can help families provide their child with the necessary lifelong care they may require.

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Leading Causes of Birth Injury Malpractice

When doctors, nurses, or other healthcare professionals commit medical negligence before, during, or after delivery, it can result in injuries to a mother, her child, or both. Even though not every birth injury is caused by medical malpractice, an experienced birth injury attorney can help make sure your child is compensated fairly if their provider was negligent in their care.

There are several examples of acts of medical negligence that can cause birth injuries during childbirth:

• Failure to recognize and treat signs of maternal or fetal distress, such as lack of oxygen
• Improper use of forceps or a vacuum extractor
• Using too much force during delivery
• Failure to schedule an emergency cesarean section (C-section)
• Delaying in performing an emergency C-section
• Failure to properly monitor the mother during her pregnancy
• Failure to administer the proper antibiotics or administering the wrong antibiotics to a mother with an STD or other maternal infections before delivery
• Ignoring or misreading a fetal monitoring strip
• Failure to detect and treat an umbilical cord complication
• Failure to diagnose and treat preterm labor in a timely manner
• Failure to treat maternal elevated blood pressure (preeclampsia)
• Failure to properly resuscitate a newborn after delivery
• Failure to treat jaundice and kernicterus
• Failure to respond to signs of a placental abruption
• Failure to detect a severe birth defect on a prenatal ultrasound
• Failure to carefully manage an abnormal fetal position
• Administering too high a dose of labor-inducing medications like Pitocin

Failing to address complications such as a preterm delivery or umbilical cord issues can result in a serious birth injury. As leaders in our communities, we rely on medical professionals to provide high-quality health care. Generally, when people think of medical malpractice liability, they picture doctors and nurses. However, other parties involved in the care of a pregnant woman and her baby may also be held responsible in a birth injury lawsuit.

Medical negligence may be committed by one or more of the following types of medical providers or facilities:

• Obstetricians (OB-GYN)
• Other obstetric professionals
• Pediatricians, including pediatric neurologists
• Anesthesiologists
• Labor and delivery nurses
• Midwives
• Nurses
• Hospitals and medical facilities
• Hospital administrators
• Other hospital staff
• Neonatal nurses and aids
• Neonatologists or pediatricians providing neonatal care
• Respiratory therapists
• Maternal-fetal medicine physicians and specialists (MFM)
• Laboratory staff

Although medical malpractice suits are often filed against healthcare providers like doctors and nurses, hospitals can also be held liable in certain circumstances. A hospital can be vicariously liable for an employee's negligent actions that caused harm during work hours or while the employee was performing a job-related task. For example, if an OBGYN makes a negligent mistake during pregnancy or delivery, the hospital can be held vicariously liable.

A hospital may also be held directly liable for its own actions. For instance, a hospital failing to adhere to medical protocols and standards may be directly liable for a patient's injuries. We can help you determine whether your child's birth injury was caused by a doctor, the hospital itself, or another medical professional.

When you file a birth injury malpractice claim, your lawyer must be prepared to present evidence that proves that a doctor's or hospital's negligence caused your child's birth injury. An injured plaintiff must be able to prove each of the following four legal elements in their birth injury lawsuit.

• Duty of care: Before the provider will have a duty of care, the plaintiff must be able to establish a provider-patient relationship. Upon establishing this relationship, the medical provider is expected to meet a relevant standard of care that a medical professional with the same specialization would have exercised under the same conditions.
• Breach: The next element the plaintiff must prove is that the healthcare provider or facility breached that duty by failing to meet the applicable standard of care.
• Causation: The plaintiff must then demonstrate that the healthcare provider's negligent care directly caused their or their child's injuries.
• Damages: Finally, the plaintiff must show that the harm they or their child suffered resulted in specific expenses and other losses. These losses may include anything from the cost of lifelong medical care to emotional suffering.

The plaintiff's attorney must present compelling evidence to establish liability and recover damages in birth injury cases. At Miller Weisbrod Olesky, our birth injury lawyers can collect evidence on your behalf, consult with medical experts to determine the cause of the injury, and identify all medical professionals who contributed to you or your child's birth injury.

Filing a Birth Injury Malpractice Lawsuit

Parents may file a birth injury lawsuit on behalf of their child against negligent medical professionals responsible for causing their child to sustain a preventable birth injury. Families may seek compensation to cover their child's medical and treatment costs through a Birth Injury Malpractice lawsuit.

It is important to note that while every case is different, most lawsuits typically follow a similar process. If your child was injured by a doctor, nurse, or other healthcare provider, an experienced birth injury lawyer can file your case, gather evidence, and pursue full and fair compensation on your behalf.

Free Case Review

Our dedicated birth injury lawyers will determine if you are eligible to file a birth injury lawsuit during your complimentary case review, which you can schedule by contacting us via our toll-free line at (888) 987-0005 or by filling out our convenient online form. If we can determine that medical malpractice may have played a role in your child's birth injury, your case will likely be accepted by our team.

Gather Evidence

A birth injury malpractice attorney will gather information and evidence related to your case as soon as they determine you qualify to pursue a lawsuit. Evidence like medical records, witness statements, and the employment history of the medical professional in your case are crucial to proving that your child's birth injury was caused by medical negligence.

File the Lawsuit

After gathering the necessary information, your attorney will file your lawsuit in the appropriate court. As soon as the case is filed, you and your family will become the plaintiffs (the party taking legal action). The healthcare professionals who may be responsible for causing your child's injury will become the defendants (the party being sued). The statute of limitations in each state governs the deadline for filing a birth injury lawsuit.

Your lawyer will ensure your case is filed on time according to your state's statute of limitations. The lawsuit outlines the charges against the defendants and gives them around 30 days to respond. If the defendants fail to respond, judgment will automatically be entered in the plaintiff's favor. In the event the defendants respond but fail to assume responsibility, they will explain why they believe they are not to blame for your child's injury.

Discovery

Your attorney will gather more evidence, such as medical records, medical expense reports, and other documents related to your case, once the defendants file their response. During this time, you, your loved ones, and medical experts may be required to give statements under oath. The parties will also exchange information and evidence relevant to their respective cases to build strong arguments. To prove that medical professionals failed to uphold a high standard of care, an experienced attorney will collect all legally required evidence.

Settlement Negotiations

Settlement negotiations can begin once both parties have prepared their cases. During this phase, both parties will try to reach an agreement (settlement) that allows them to resolve their dispute without going through a full trial. Should a settlement be reached, the defendants will pay you a lump sum, and all legal action will stop. If the case cannot be resolved during this stage, our lawyers have the experience and knowledge to represent your best interests in court.

Go Through a Trial

Cases that do not settle through settlement negotiations will go to trial. A jury and judge will examine all the evidence presented by both legal teams during the trial. A verdict is reached after each party has presented their case and a judgment has been entered. The losing party may decide to appeal the decision in some cases. The disadvantage of trials is that, while you might receive more compensation than you would receive from a settlement, you risk receiving no compensation at all if you lose. Our lawyers can help you obtain the compensation you need to cover the cost of your child's care and other injury-related expenses.

Birth Injury Malpractice Statute of Limitations

A statute of limitations is a law that imposes a deadline for filing birth injury lawsuits. If you fail to file a claim before the statute of limitations "runs out", you may lose your right to pursue legal action and seek compensation. In some cases where an injury may not be immediately apparent, the statute of limitations may be extended.

The discovery rule prevents the statute of limitations from running until the injury is discovered or reasonably should have been discovered. It is also important to remember that the statute of limitations varies by state and the type of claim you're filing. A birth injury attorney can help you avoid missing all crucial deadlines related to your case.

Contact Us Today to Learn More About Your Legal Rights and Options

When doctors and other healthcare professionals fail to do their jobs, what should be a joyous moment can quickly become a nightmare for expecting parents and their families. Even the slightest medical error before, during, or immediately after childbirth can result in serious, life-altering birth injuries that can have lifelong consequences for the child and their family.

At Miller Weisbrod Olesky, our experienced birth injury attorneys know how devastating it is to watch your baby suffer, especially when you know the harm could have been prevented. If you suspect your child was the victim of medical malpractice, you may be eligible for compensation. We encourage you to schedule a complimentary case review with one of our birth injury lawyers, who can evaluate the details of your case and determine if medical negligence occurred. We work on a contingency fee basis, meaning you NEVER pay any upfront fees unless/until we successfully recover compensation in your case. Call us at (888) 987-0005 or complete our online form to set up your free consultation today.