Spinal Cord Injury At Birth

• Birth Complications
• Spinal Cord Injury At Birth

Spinal Cord Birth Injury

Neonatal spinal cord injury is a birth complication of birth trauma that may occur when the medical providers strain the baby’s neck by twisting, pulling, or using assistive devices to remove the baby from the birth canal. Spinal cord injury during delivery may also result from undiagnosed spinal damage that occurred before birth.

Spinal cord injury at birth disrupts the nerve connections between the baby’s brain and the rest of the body, typically resulting in catastrophic long-term consequences, such as limb weakness or paralysis, respiratory complications, or even the baby’s death.

Neonatal spinal cord injury sometimes occurs concurrently (at the same time) with hypoxic-ischemic encephalopathy (HIE), which may lead to cerebral palsy. Typical manifestations of this birth complication include loss of movement or decreased movement, slow or no reflexes, breathing difficulties or apnea, and absence of response to painful stimulation.

Poor medical judgment or negligence of the obstetrics team is often involved when a baby is diagnosed with spinal cord injury. The parents may have strong grounds for a medical malpractice case, if spinal cord injury occurring at the time of delivery was preventable, or further neural damage could have been avoided with early diagnosis and appropriate neuroprotective treatment, such as hypothermia therapy.

In cases of neonatal spinal cord injury, negligent use of forceps or vacuum extractors, excessive application of force while removing the baby from the birth canal, failure to react to fetal distress during labor or delivery, or the failure to recommend a cesarean delivery when it was the best course of action available particularly in a condition of fetal distress or prolonged/arrested labor often constitute medical malpractice.

Causes of Spinal Cord Injury at Birth

The ligaments and vertebrae that protect the spinal cord are still developing in newborns. Therefore, prolonged or excessive pressure applied on the baby’s spine during the birth process can cause neonatal spinal cord injury. Here are some of the notable causes of this condition:

Excessive Strain on the Baby’s Spine or Neck

If the birth attendants (obstetricians, labor and delivery nurses or midwives) use excessive twisting or pulling (known as excessive extraction, hyperextension, or rotation of the baby’s spine or neck) during delivery, it can result in neonatal spinal cord injury. In a vertex (head-first) delivery, the upper and mid cervical spine may be injured, while in a breech (feet or buttocks first) delivery, the upper thoracic and lower cervical region are usually involved.

Rushed Delivery

In a case of umbilical cord compression, the severity of blood loss in the mother or fetal hypoxia (oxygen deprivation of the baby) may prompt the medical team to rush the delivery. Failure to identify fetal distress, delayed diagnosis, lack of coordination among the medical team members leading to preventable delays, or poor judgment to avoid cesarean section may contribute to a rushed delivery and resulting spinal cord injury.

Other Risk Factors

• Assisted vaginal delivery with the use of midcavity forceps or vacuum extraction
• Abnormal fetal presentation (in particular, breech presentation)
• Prolonged or arrested labor
• Labor is too rapid
• Premature birth
• Cephalopelvic Disproportion (baby’s head is too large for the maternal pelvis)
• Shoulder Dystocia (the baby’s head gets stuck in the maternal pelvis during delivery)
• Macrosomia (larger than average size of the baby)
• Spina Bifida undiagnosed (spinal bones are not fully formed, resulting in unprotected spinal cord. Lack of prenatal diagnosis increases the risk of spinal cord injury at birth.)
• Oligohydramnios (low amniotic fluid volume)
• Primigravida (first-time pregnancy of the mother)

Signs and Symptoms of Neonatal Spinal Cord Injury

An alert medical provider should be able to identify signs of spinal cord injury at birth immediately during the post-delivery physical examination. But in some cases, the signs of injury may appear after a few days. Signs and symptoms include:

• Abnormal reflexes or lack of reflexes
• Weakness in muscles or paralysis
• Muscle spasms
• Breathing difficulties
• Low APGAR scores
• Baby appears floppy (limp) when picked up
• Lack of movement in some areas of the body
• Lack of sensation in some areas of the body
• Changes in bladder or bowel function
• Curled feet or hands
• Excessive sleepiness
• Excessive drooling
• Feeding difficulties
• High-pitched cries or irritation
• Sensitivity to light
• Seizures
• Slow heart rate
• Low levels of oxygen

Types of Neonatal Spinal Cord Injury

• Cervical Spinal Cord Injury: It affects the uppermost part of the spinal cord, located in the neck. It may cause loss of motor function and sensation in most areas of the body (paralysis in both legs and arms, known as quadriplegia).
• Thoracic Spinal Cord Injury: It affects the thoracic area of the spinal cord, which is located in the mid-back. It rarely affects the arms, but the legs and some parts of the torso can be severely affected with this injury.
• Lumbar/Sacral Spinal Cord Injury: It affects the lower part of the spinal cord, generally resulting in paralysis in the lower limbs. Based on this, the injury can disrupt the pathways controlling the bowels and bladder, causing poor control of these functions.

Diagnosis of Spinal Cord Injury at Birth

The prognosis of spinal cord injury at birth is poor (which means, the rate of death and long-term disability is high). Therefore, early diagnosis and proper treatment is critical to prevent further neural damage. The medical provider should be familiar and alert to the symptoms of spinal cord injury during delivery and should be able to differentiate the symptoms from neuromuscular diseases, hypoxic-ischemic encephalopathy (HIE), and brachial plexus injury.

When neonatal spinal cord injury is clinically suspected, a full medical evaluation should be conducted and the baby should receive prompt medical care. Apart from review the medical history and conducting a physical examination, the medical provider should order x-rays, CT scans and/or MRIs as well as blood work to confirm the diagnosis.

Treatment of Neonatal Spinal Cord Injury

Although a severe spinal cord injury at birth may cause permanent damage, a range of medical interventions are available to reduce additional damage and optimize body function. These include:

• Immobilization of the spine using special devices
• Corticosteroids
• Surgery
• Physical therapy
• Supportive treatment
• Occupational therapy
• Mechanical ventilation
• Feeding tube insertion
• Bladder catheterization

Hypothermia Therapy for Spinal Cord Injury at Birth

Some babies with neonatal spinal cord injury may qualify the criteria for therapeutic hypothermia (body cooling therapy). There is growing medical evidence to show that the neuroprotective effects of hypothermia therapy may improve the secondary mechanisms of neonatal spinal cord injury.

According to researchers, considering the potentially dangerous consequences of spinal cord injury in newborns, and the extensive recorded evidence of safe use of therapeutic hypothermia in infants, it is useful to apply moderate whole-body hypothermia therapy as soon as possible after birth for babies with spinal cord injury.

This cooling therapy should be initiated within six hours after the baby’s birth to achieve beneficial effects. If the medical providers miss this crucial time window due to delayed diagnosis or delays in initiating the treatment, the baby may fail to receive the neuroprotective benefits of therapeutic hypothermia.

Is Your Child’s Birth Injury the Result of Medical Malpractice?

Parents whose children suffer from spinal cord injury related birth trauma or birth complications want and deserve answers as to the cause of their child’s birth injury and whether mistakes by the doctors and nurses contributed to the injury.

• Were there signs of birth injury or birth complications during the pregnancy, labor, and delivery process, or presence of risk factors, which were either not recognized or properly treated?
• During the labor and delivery, were there clear indications that the baby was suffering from fetal distress, but appropriate actions were not taken by the obstetrician or nurses?
• Was there a delay in diagnosis of the neonatal spinal cord injury that led to later complications, including brain injury?
• Did the medical team fail to order a series of tests to diagnose this birth complication in a timely manner?
• Was the decision to perform a cesarean delivery delayed leading to birth trauma during vaginal delivery or labor?
• Did the neonatal resuscitation team fail to quickly begin important breathing support?
• Should brain cooling (also called “hypothermia therapy”) have been provided to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?

Our national birth injury attorneys have extensive experience in this and all areas of birth injury medical malpractice. The lawyers and nurses at Miller Weisbrod Olesky will help you determine if mistakes of the medical providers caused a birth injury to your child, including Hypoxic-Ischemic Encephalopathy (HIE) or cerebral palsy.

Our award-winning birth injury attorneys represent families all over the United States in their time of need after a wrongful birth. We use our skills and expertise to obtain for you and your child a medical malpractice settlement that will help provide specialized medical therapy in order to maximize the quality of life and independence of your child throughout their life.

Sometimes families are reluctant to contact a medical malpractice lawyer. It’s also not uncommon for parents to feel overwhelmed by the responsibilities they encounter in caring for their injured child and worried that they will not be able to help out in a lawsuit involving their child’s birth injury. Our birth injury attorneys and nursing staff will address these hesitations and concerns, so you can focus on your child and maximizing their care.

Registered Nurses and Nurse-Attorneys Are a Vital Part of Our Birth Injury Team…and Yours

Most birth injury law firms will employ one or two nurses to assist the review of cases and medical research. But Miller Weisbrod Olesky offers an unmatched number of nurses and nurse-attorney employees support to both the birth injury attorneys and our clients.

Our team of registered nursing staff and nurse-attorneys bring a deep level of medical and personal insight to every client’s case. Our nursing team includes both an experienced labor and delivery nurse as well as an ICU nurse. Working closely with the rest of the team, they investigate the reasons behind a birth injury and how medical professionals breached their standard of care.

Why Should You Talk with the Highly Capable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to a lawyer experienced in birth injury lawsuits. It’s not uncommon that a birth related complication results in a preventable birth injury, including cerebral palsy, but it takes a detailed expert review by a birth injury attorney of the medical records from your child’s birth to determine if the birth injury was the result of medical malpractice.

At Miller Weisbrod Olesky, a team of committed lawyers, nurses and paralegals uses our detailed medical negligence case review process to assess your child’s potential birth injury case. We start by learning more about you and your child and the status of meeting/missing developmental milestones. Then we gather medical records to determine what happened before, during pregnancy. We call in documented and proven medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.

If we feel medical negligence caused or contributed to wrongful birth in your case, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. Our birth injury attorneys have recovered millions of dollars in settlements for families of children that have suffered a birth injury.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do no matter how long or tough your case is.

Contact Our Birth Injury Lawyers