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Low Vitality Scores and Cerebral Palsy

The Lancione Law Firm

A recent study published in the British Medical Journal found that low vitality scores at birth are associated with the development of cerebral palsy in infants. Cerebral palsy is a disorder that impairs the part of the brain that controls a person’s muscle coordination and movement. Lack of oxygen to the brain during birth is one of the causes of cerebral palsy.

After birth, all babies are given a vitality (also known as an Apgar score). Apgar scores are scaled from zero to 10, with babies receiving seven to 10 considered within the normal range, four to six considered fairly low and three or less critically low. Apgar scores are based on five criteria: breathing, appearance, muscle tone, pulse rate and reaction when stimulated.

The study found that children with an Apgar score of three or less had a 100 times greater incidence of developing cerebral palsy than children scoring 10. However, the study also found that even among babies receiving a four or lower vitality score, 90 percent of them did not develop cerebral palsy.

Based on their findings, the researchers believe that cerebral palsy is closely related to factors that reduce an infant’s vitality and that low Apgar scores may indicate the infant’s brain was impaired during the mother’s pregnancy or delivery.

Erb’s Palsy and Other Birth Injuries

Cerebral palsy is just one type of birth injury. Another potentially serious birth injury is Erb’s palsy, which is caused by stretch injuries to the brachial plexus, a network of nerves located near the baby’s neck that control movement down the arm and into the hands and fingers. On average, one to two babies out of every 1000 born in the U.S. have Erb’s palsy.

Erb’s palsy injuries often are the result of difficult deliveries. This can happen when the baby is in breech position and in cases when the baby is large, making labor and delivery more difficult and take longer. Erb’s palsy also can occur in cases when the baby must be delivered quickly and the treating physician has to use force to remove the baby, either manually or with the help of a vacuum or forceps. In these cases, the baby’s neck can be stretched – and with it the brachial plexus – leading to the development of Erb’s palsy.

Babies with Erb’s palsy may still be able to move their arms and fingers, so a child could be affected by the disorder but still have some function in the arm and hand. The child’s doctor will look for weakness in one of the arms and also may order X-rays and other diagnostic tests to determine if the baby has suffered the nerve injury. Parents who notice that their child is favoring one arm more than the other or not using one of the arms at all should notify their pediatricians.

Most babies with Erb’s palsy recover from the injury and regain movement and feeling. Other babies, however, will not and may suffer permanent loss of function in the arm.

In addition to cerebral palsy and Erb’s palsy, other types of birth injuries include:

  • Hypoxic Ischemic Encephalopathy (a general term for injuries caused by insufficient blood and oxygen supply to the brain)
  • Subconjunctival hemorrhage (eye-bleeding)
  • Caput succedaneum (bruising and swelling of the baby’s scalp)
  • Cephalohematoma (bleeding underneath the cranial bones)
  • Broken bones
  • Bruising and lacerations

Contact an Experienced Med Mal Attorney Today

During labor and delivery, the treating physician and support staff are responsible for monitoring the mother and baby’s vital signs, including their heart rates and oxygen levels for signs of distress. When these signs are not properly monitored or when the doctor falls to take appropriate action in response to distress indicators, like performing a timely C-section, a birth injury can occur. While many birth injuries are minor, some are very serious and can result in life-long impairments to the child or even death.

It can be very difficult to determine whether a birth injury is the result of medical malpractice. An attorney experienced in handling medical malpractice cases can review your circumstances and help determine whether a health care provider’s negligence caused your child’s birth injury. For more information, contact a medical malpractice lawyer today.

If you or a loved one has been injured at birth, you may be entitled to medical malpractice compensation. To see if you have a case please call The Lancione Law Firm at (440) 220-4439 or email us. There are no fees until we recover for you.


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