Two Types of Oxygen Deprivation That Can Cause Birth Injuries

Infant in Palm of HandsThere are two types of oxygen deprivation that can cause problems for a fetus or infant during (or after) delivery:  Hypoxia and anoxia.  Both are potentially life-threatening medical conditions that need to be quickly identified and corrected because when oxygen levels become too low brain damage and death can occur.

  • Hypoxia is low oxygen concentration in the blood. Even partial oxygen deprivation (or, when there is too little oxygen for the baby), can be sufficient to cause mild brain damage, mental impairment, and cerebral palsy.
  • Anoxia is the total absence or depletion of oxygen concentration in the blood.  When complete deprivation of oxygen occurs it often leads to severe brain damage to the baby, including cerebral palsy, mental impairment, or infant death.

What are perinatal asphyxia, neonatal asphyxia, and birth asphyxia?

Asphyxia is a medical condition that can be the result of oxygen deprivation.  It is the total absence or depletion of oxygen concentration in the blood.

Perinatal asphyxia, neonatal asphyxia, or birth asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain.

Birth asphyxia is extremely serious and potentially catastrophic.  If your baby stops breathing for only a few seconds causing hypoxia, or for longer causing anoxia, your baby is at high risk for severe brain damage, including, Hypoxic Ischemic Encephalopathy (HIE), cerebral palsy, mental impairment, or infant death.

What can cause asphyxia during pregnancy and delivery?

Asphyxia can be caused by injury to or obstruction of breathing passageways,such as in strangulation or the aspiration of food (choking) or large quantities of fluid (near-drowning or drowning).

The aspiration of food or fluid can result in a shrunken and airless state of the lungs that is known as atelectasis, a condition that aggravates hypoxemia. Asphyxia can also be caused by suffocation, the inability of sufficient oxygen to reach the brain, as in carbon monoxide poisoning.

Causes of fetal and infant asphyxia include:

  • Contractions that are too close together either due to naturally occurring uterine contractions, or caused by too much medication used to stimulate contractions (i.e. due to the administration of Cervidil,, Cytotec, and Pitocin);
  • Prolapsed umbilical cord;
  • Maternal infections;
  • Eclampsia and preeclampsia;
  • Physical trauma during labor and/or delivery process; and
  • Fetal distress, such as shoulder dystocia, which can trap the baby delaying delivery or exposing the baby to the risk of asphyxia if contractions squeeze the infant’s neck.
What can cause hypoxia/anoxia during pregnancy and delivery?

Hypoxia / hypoxemia is a condition in which there is an inadequate supply of oxygen in the blood and can be caused by several things:

  • A reduction in partial pressure of oxygen
  • A blocked airway
  • Inadequate oxygen transport
  • The inability of the tissues to use oxygen
  • Lung diseases including pulmonary fibrosis, pneumonia, pulmonary edema, chronic obstructive pulmonary disease (COPD) was well as other lung problems
  • Congenital heart disease
  • Anemia
  • High altitudes where oxygen levels are reduced
  • Sleep apnea
What is cerebral hypoxia?

Brain hypoxia, also called cerebral hypoxia, is a condition caused by decreased oxygen in the brain (even though there may be adequate blood flow.)

Birth complications, drowning, strangling, choking, suffocation, cardiac arrest, head trauma, carbon monoxide poisoning, and complications of general anesthesia can create conditions that can lead to cerebral hypoxia.

What are symptoms of cerebral hypoxia?

Symptoms of mild cerebral hypoxia include inattentiveness, poor judgment, memory loss, and a decrease in motor coordination. Brain cells are extremely sensitive to oxygen deprivation and can begin to die within five minutes after oxygen supply has been cut off. When hypoxia lasts for longer periods of time, it can cause coma, seizures, and even brain death.  In brain death, there is no measurable activity in the brain, although cardiovascular function is preserved. Life support is required for respiration.

What is hypoxic-ischemic encephalopathy (HIE) (or intrapartum asphyxia)?

Hypoxic-ischemic encephalopathy (HIE) is a type of brain injury that occurs when there is a lack of oxygen (asphixia) to the brain.  HIE is also commonly called intrapartum asphyxia.  When in infant’s brain is deprived of oxygen for too long delicate brain tissues are destroyed and often results in death.

Hypoxic-ischemic encephalopathy due to fetal or neonatal asphyxia is a leading cause of death or severe impairment among infants.  The gestation age of the fetus plays a critical role in which portion of the brain is injured by asphyxia and, therefore, the challenges and prognosis of infants varies significantly from infant to infant.

What can cause HIE (intrapartum asphyxia?

Medical negligence can increase the risk of HIE, but not every instance where a fetus suffers brain damage is due to medical negligence.  The following are risk factors for HIE, regardless of whether they were unavoidable or caused by or made worse by medical mistakes:

  • Asphyxia
  • Fetal stroke
  • Problems with blood loss, volume, flow, and maternal blood pressure from a medical condition, intrapartum hemorrhage, placental abruption, or ruptured uterus.
  • Maternal lung diseases affecting oxygen exchange
  • Cardiac complications in either the mother or the fetus
  • Infant injury from a “failure to progress” or from cephalopelvic disproportion (when the infant is too large to pass through the mother’s pelvis)
  • Injuries to the fetus such as from umbilical cord complications such as a prolapsed cord, or other medical problems that cause impaired blood flow to the brain, or a stressful labor and/or delivery.
  • Too much pressure during labor or delivery on the cranium may result in decreased blood flow, insufficient oxygen and/or brain bleeding.
  • Ruptured vasa previa (an obstetric complication in which fetal blood vessels cross or run near the external orifice of the uterus and are at risk for rupturing.).