Microcephaly Birth Injuries

Microcephaly is loosely defined as an abnormally small head, oftentimes associated with incomplete development of the brain.  Sometimes the cause is known and sometimes it is not. This serious medical condition is being thrust into the spotlight after recent reports from Brazil that a virus, perhaps present in the drinking water, may be responsible for causing microcephaly in unborn babies.

What is Microcephaly?

Children with microcephaly have heads that are significantly below normal size for their age (typically well below the first percentile).  There are several problems related to microcephaly, including abnormal brain development,intellectual disability, seizures and lower life expectancy.

Depending on the cause, a diagnosis of microcephaly may be made immediately after birth, or it may take a few months or years to determine if the head is growing properly.  Scans of the brain, such as CT scans or MRIs, will help to determine whether there is cause for concern.

Microcephaly may be congenital or acquired.  Congenital means it was present at birth.  Acquired means that it manifested itself sometime after birth when head size is normal.  Common acquired microcepahly is often secondary to hypoxia and/or ischemia around the time of birth.  One example of congenital microcephaly is that seen from the Zika virus where the head size is small at birth.

What is Happening in Brazil?

In Rio de Janeiro, health officials are making a significant request, asking people to avoid pregnancy.  The reason is simple—there are 2,975 reported cases of newborn microcephaly this year, compared with 147 last year.  That is a jump of over twenty times.  Among these 2,400 cases, there are 40 deaths being investigated.

In some states, like Pernambuco, there are high concentrations of microcephaly.  There have been over 900 reported cases in that state, alone.  There and elsewhere, doctors notice the rise in microcephaly, and deduced that it was related to an increase in the Zika virus.  Mothers who had given birth to children with microcephaly often had symptoms of rash, headaches and fever early in pregnancy, just like others with the virus.

Zika has been seen in Africa and Asia, then spread in 2007 to Micronesia.  In Brazil, it has been tentatively linked to foreign visitors from the 2014 FIFA World Cup and insects (particularly a mosquito called Aedes aegypti), which helped to spread it.  Cases have also been seen recently in the United States.  In adults, the flu-like symptoms are relatively mild.

Early research indicates that the Zika virus is not limited by the placental barrier, which is how it affects unborn children.  Efforts in Brazil are now focused on reducing the virus-spreading mosquitos.

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Certainly, pregnant women should take care in determining whether to travel to Brazil or other areas known to be dealing with the Zika virus.  Though it has not been identified conclusively as the cause, the sheer numbers of affected babies indicated that something is wrong, and more information may be needed before safe travel is possible.  If you have questions about acquired or congenital microcephaly, contact us at 855.712.7818, or send us your questions online.

5 Ways Hospitals Can Make Childbirth Safer

Preventable in-hospital errors are the third leading cause of death in the United States after heart disease and cancer. An estimated 250,000 lives are claimed each year by medical errors which cost the nation $1 trillion in added healthcare costs. The statistics are chilling, no doubt. Would we tolerate two 747’s crashing every day? Or 9/11 occurring twice a week?

Childbirth is particularly prone to medical negligence. Obstetricians are one of the most highly sued specialties in malpractice lawsuits. Medical errors result in more than 25,000 infants being born with birth injuries each year.  Some of these injuries are severe and permanent and some are not.

Yet, hospitals can make childbirth safer by stressing on a comprehensive obstetrics patient safety program. A study conducted by researchers at the Yale School of Medicine and published in the American Journal of Obstetrics and Gynecology showed that malpractice claims fell by 50 percent when the Yale-New Haven Hospital in Connecticut standardized obstetric care, improved communication and teamwork, and optimized quality review. Malpractice payments at the hospital fell from approximately $50 million to approximately $3 million in the 5 years after the program was implemented.

Similar findings were reported by the New York Weill Cornell Medical Center. An obstetrics safety program at this institution resulted in fewer adverse events and lower compensation payments. The results were a 99% drop in average claim payments and no obstetric malpractice lawsuits at the end of the 6-year period.

Here are some of the things hospitals can do to make childbirth safer:

Electronic charting:

Electronic health records (EHRs) may enhance patient safety and lower the possibility of medical errors. EHRs help physicians adhere to standard medical practice, for instance, by choosing the correct laboratory test. Specific features in the program can alert a physician about a possible medication error.

Dedicated attending obstetrician:

A dedicated on-call attending obstetrician at a hospital means that a doctor attending to one patient is not pulled away to consult on another patient. On a busy labor and delivery floor, having a senior obstetrician overseeing the department can have a considerable positive impact on patient safety.

Standardized protocols:

Hospitals that have standardized protocols for the most commonly encountered clinical and surgical scenarios have a better safety record. For instance, oxytocin (Pitocin) is a drug given to induce women who are full-term and have not gone into spontaneous labor. Hospitals that have a standard protocol for Pitocin administration and a checklist for patient safety have a better chance of identifying situations that could be potentially harmful to the mother or the baby.

Color-coded safety labeling:

During childbirth, many different drugs are given to the mother, many of which can cause significant harm if given incorrectly or outside safe dosages. Color-coded safety labeling on pre-mixed drugs and solutions can help avoid inadvertent or accidental overdoses. Color coding helps lower the chance of confusion between similar looking medications, mislabelling, misreading a physician’s order, and communication errors. When hospitals follow color coding of IV lines and pre-mixed infusion bags, the incidence of drug errors is reduced.

Electronic fetal heart monitoring:

During labor, the baby’s heart beat is often monitored electronically. This tells the obstetrician how well the infant is coping. If an obstetrician or nurses fail to note signs of distress on the fetal heart rate monitor, it could result in an adverse event.  Hospitals that employ obstetrical nurses with an added qualification in the interpretation of electronic fetal heart rate monitoring have better safety records.

The Best Toys for Girls and Boys with Disabilities

Ask any parent and they’ll tell you that choosing a toy for their child can be incredibly difficult. And when you have a special needs child, the challenge is even greater. Whether you are planning an activity or buying a toy, it needs to be fun, but it also needs to be safe.

Younger children tend to be less fussy. A toddler will happily spend hours playing with a cardboard box. But parents need to pay attention to the toys they are buying because toys are important tools that stimulate a child’s physical, mental, emotional, and social development.

Here are some guidelines to help you choose toys that will have your little one enjoying themselves while also safely promoting development.

Keep it simple:

Overly complicated toys can be intimidating to kids with special needs. Also, toys that don’t do too much are better at sparking a child’s imagination and encouraging creativity.

Limit electronics:

Keeping kids as young as 12 months old away from electronics and computers is becoming difficult. But, limiting the amount of time spent on electronic toys is crucial. Video games, for instance, encourage passive learning, reduce attention span, and are associated with language and developmental delay. Avoid giving electronics to children less than 2 years old and limit screen-time for older kids to 1-2 hours per day.

Don’t fall for “educational”:

Not all toys that claim they are “educational” are really going to boost your child’s brain development. A flashy gizmo is less likely to produce a mathematician than a simpler toy that encourages creative thinking.

Less is more:

We all tend to spoil our kids by inundating them with toys, and parents with special needs kids may try to overcompensate. But too many toys can make it hard for the child to focus. Rotating and re-introducing toys can make them feel new. Something as simple as blocks can take a child through many different stages of development.

Here are some age-appropriate toys that can help with muscle tone, movement, and posture in your special girl or boy:

0-12 months:

• Soft blocks in bright colors to squeeze and grasp
• Play mats and baby gyms to encourage pulling and kicking to strengthen hand and foot muscles
• Mobiles, rattles, and chimes to discover sound and movement
• Comfortable tummy-time cushioned supports to strengthen neck and back muscles
• Smaller toys to encourage hand-to-hand transfer

1-3 years:

• Bigger, more chunky blocks that are easily grasped by children with involuntary, spastic movements
• Tent-and-tunnel combos for kids to escape an overstimulating world
• Pretend-play toys that encourage social development
• Activity cubes that offer support and stimulating surfaces
• Specially-designed toddler high-chairs for special needs kids to promote good posture

3 years and up:

• Inflatable bouncy toys to improve balance and coordination and engage many different muscle groups
• Chunky crayons, Play-Doh, and finger paints to spark imagination
• Large puzzles, blocks, and construction toys to help fine and gross motor skills
• Drums and musical instruments for acoustic stimulation in kids with sensory integration impairments
• Flexible, open-ended crafts like paint-a-rock that give plenty of 

Is that C-Section Necessary? Assessing the Need for the Risky, Overprescribed Procedure

In recent years, cesarean sections (c-sections) have become somewhat controversial.
To many, c-sections have been decried as an overprescribed, risky procedure used by
 doctors and hospitals to simply increase their billable charges.

According to the National Center for Health Statistics (NCHS), the c-section rate
nationwide increased more than four-fold in a little less than 20 years, rising from 5.5 
percent in 1970 to 24.7 percent in 1988. Today, nearly one in four pregnant women now
have a cesarean.

A c-section, while at times is a life-saving intervention for both mother and child, carries
risks of harm, particularly to the mother, if the practice is performed outside of certain
well-defined medical situations. C-sections, like any abdominal surgery, should not be
performed unless medically necessary. However, nonetheless, data seems to show the
procedures are still happening on a frequent basis.

What is a C-Section?

A c-section is an alternative birthing method used by doctors. In a c-section, the baby
is not delivered by the traditional vaginal means, but through an incision made by the doctor
in the abdomen of the mother. The physician makes the incision, removes, the baby, and
stitches up the womb.

What are C-Section Complications?

The dangers of a c-section lie in the location of the incision (the lower abdomen near other vital organs surrounding the uterus). The complications for the mother from a c-section include:

• Risk of increased bleeding from the incision
• Threat of infection, especially in hospitals where antibiotic-resistant staph infections exist
• Negative reactions to drugs or anesthesia used during the procedure
• Potential for blood clots after the surgery

When is a C-section Recommended?

In some cases c-sections are helpful and can even be life-saving procedures for a baby;
such as when a baby suffers from what is known as fetal distress.

Fetal distress is a broad term that is used to describe a situation where the baby’s heart
rate is abnormal. This type of stress on the baby can result in potential development of
cerebral palsy due to oxygen deprivation or nerve damage during a difficult birth. In
these circumstances, a doctor or hospital staff’s failure to act quickly enough could be
grounds for medical malpractice.

If you or your baby has suffered injuries due to complications from labor or birth,
speaking with an experienced birth injury lawyer is recommended. Your attorney can
speak with you about your situation and assess potential options available under the law.

Ohio Medical Malpractice Lawsuits Prove Complex, Lengthy & Expensive

Human error is inevitable at some point in most every circumstance. However, when mistakes are made by medical personnel treating patients, these mishaps can literally mean the difference between life and death. Medical mistakes can include operating on the wrong area of a patient’s body, birth injuries caused by improper prenatal care, and prescribing the wrong medication (or the wrong dosage of the correct medication). When medical errors occur, many patients can pursue compensation under the law for injuries they sustained as a result of the hospital or doctor negligence. However, obtaining compensation in the legal system for these types of injuries is much easier said than done.

Do I Have an Ohio Medical Malpractice Case?

Medical malpractice lawsuits, including Ohio medical malpractice claims, can be a lengthy and expensive process. In order for patients to win their cases, they must have medical experts testify on their behalf about the mistakes that were made by the medical personnel who provided treatment. And even with this assistance, there is no guarantee that the lawsuit will be successful.

Before a patient considers suing a doctor for malpractice a few important questions should be asked:

• What injuries were sustained? Injuries are not easy to prove because patients usually don’t seek care initially if they don’t already have an existing problem. In order to win a lawsuit, patients must be able to prove that their condition was worsened as a result of the medical care that they received.

• Was the injury caused by negligence and a standard of care that fell below the industry standard?Medical professionals are expected to meet certain standards accepted throughout the profession. Medical malpractice plaintiffs must prove that these standards were not adhered to during their care. In addition, plaintiffs must show that their injuries would not have occurred but for the negligence of the medical professional.

• Did the injuries cause damage? It’s not enough to have suffered an injury that was caused by a medical professional’s mistake. Patients must also prove that they suffered damages as the result of the injury. In order to do this, patients must present evidence that the injury suffered caused then to lose income, become disabled or amass a significant amount of medical bills.

• When did the injury occur? Every state has a statute of limitations-the maximum time subsequent to the event that legal action can be commenced-for filing a medical malpractice suit, so be sure that you know what that timeframe is where you live.

Speaking with an experienced medical malpractice attorney is recommended. A lawyer can assess the facts and circumstances of the case and determine the appropriate course of action.

Important Information Regarding Breech Births

Every pregnant woman hopes for a safe and healthy delivery. Throughout the pregnancy, many times, they are introduced to different types of terminology. For instance, some may hear the phrase “breech birth” and wonder exactly what it means and what happens if it occurs.

Occurring in one out of 25 full-term births, a baby is in breech position when its buttocks or feet move closer to the birth canal and are positioned to be delivered first, before the head.

Situations Where Breech Births are Likely to Occur

Although the exact cause of breech births is still unknown, they are more common in women who have a history of premature delivery. Women who have given birth before or are carrying twins or triplets are also more likely to experience a breech birth.

Certain uterus characteristics also play a role in breech births. Women with unusual growths on their uterus, such as fibroids, or an oddly shaped uterus may be more prone to a breech birth.

What Happens When a Baby is in Breech Position?

If a baby is in breech position, a vaginal delivery will not be attempted due to the potential fordelivery trauma and other risks involved. Because the head is the last part of the body to emerge, it often has a hard time traveling through the birth canal.

There is also potential for squeezing of the umbilical cord as the baby makes its way through the birth canal. This reduces the supply of blood and oxygen available for the baby.

Alternative Options

There are a wide variety of birth options for babies in the breech position. Doctors normally recommend a cesarean delivery, especially for premature babies.

Some methods attempt to get the baby out of the breech position. One option is an “external version.” In this situation, the mother is given a medication to relax the uterus. The doctor then pushes gently on the abdomen in an attempt to maneuver the baby into a head first position.

Another option is called the “breech tilt” and can be tried at home with pillows. The mother raises her hips off the floor using pillows for 10 to 15 minutes a day. Other options include chiropractic techniques and even music.

Babies Born Addicted to Opiates On The Rise: Are Doctors To Blame?

Most women are aware of the dangers associated with alcohol and illicit drug use during pregnancy, but many may not know that prescription pain medications, such as Oxycodone and Vicodin, also pose dangerous risks including possible birth defects and painful syndromes affecting newborns.

A recent study published in The Journal of the American Medical Association (JAMA), indicates that the number of babies born addicted to opiates, including prescription pain relievers, tripled from the year 2000 to the year 2009.

Neonatal Abstinence Syndrome

According to the lead author of the study, Stephen W. Patrick, MD, MPH, a child born every hour of every day is born with what’s known as neonatal abstinence syndrome-a condition where babies experience the effects of withdraw from the mother’s use of opiates.

Babies with neonatal abstinence syndrome often have difficulty breathing, endure high fevers and terrible bouts of diarrhea, have low birth weights, and have difficulty feeding. In severe cases, they can experience seizures.

The main treatment for babies with the syndrome involves isolating them in rooms with low-light and little noise while also giving them extra physical attention. Some babies, however, will need to be weaned off the opiates by giving them special doses of morphine or methadone over a period of weeks or months.

Prescription Drug Misconception

One potential factor in the increase in opiate use by pregnant mothers is the misconception that prescription painkillers are safe since they have been prescribed by doctors and are made by legal, regulated pharmaceutical companies.

The study authors say that some doctors may also be misinformed about the potential problems with opiate painkillers, and, therefore, overprescribe them.

According the various health professionals, primary care doctors should take more precaution when prescribing these drugs making sure to ask plenty of questions about their patients’ drug use-prescription or otherwise, and the effects of these drugs on pregnant women and those who could become pregnant.