Michigan birth injury attorney Leon Walsh discusses oligohydramnios and how it can result in a baby developing hypoxic ischemic encephalopathy (HIE) and other birth injuries.
Oligohydramnios is a condition in which the amount of amniotic fluid surrounding the baby in the womb is less than it should be for the baby’s gestational age. A sufficient amount of amniotic fluid is very important for normal movement, growth, and cushioning of the baby and umbilical cord. When the fluid becomes too low – which is often a sign that the placenta is not functioning properly – movement and growth of the baby can be inhibited. In addition, when the fluid is low, the baby’s cord can become compressed, which can cause severe oxygen deprivation.
Oligohydramnios can be chronic (occurring over time) or acute (occurring suddenly). The cause of the oligohydramnios should be promptly investigated and properly managed because it can result in the baby developing intrauterine growth restriction (IUGR) and other problems. Oligohydramnios can also be caused by certain problems, many of which can be quite serious, which is another reason prompt investigation must occur.
When there is a diagnosis of oligohydramnios and the baby is close to term, she may need to be promptly delivered, depending on the severity of the oligohydramnios. Often, the trimester of pregnancy greatly dictates which type of treatment will be given for low amniotic fluid.
TREATMENT FOR OLIGOHYDRAMNIOS
There is no long-term treatment for oligohydramnios. However, a few things can temporarily increase amniotic fluid levels:
- Oral intake of fluids
- The obstetrical team may advise mothers to stay hydrated if they have oligohydramnios. Oral hydration is the simplest, but in some cases, intravenous hydration (through an IV) may be needed.
- Installation of a saline solution into the amniotic sac (amnioinfusion) during labor
- During amnioinfusion, the obstetrical team uses an intra-amniotic catheter to add more liquid to the amniotic fluid. This may help ‘pad’ the umbilical cord, thereby decreasing the risks of umbilical cord compression and oxygen deprivation.
- Investigational therapies
- Certain investigational therapies are used to increase amniotic fluid, including tissue sealants, a combination of hydration and DDAVP (desmopressin), and other methods.
The aforementioned techniques, if successful, are temporary. They do not treat the underlying cause of the oligohydramnios. In many cases, the condition can indicate issues with the uteroplacental circulation. In situations where the baby’s circulation might be compromised, the baby may need to be delivered in order to receive medical treatment.
OLIGOHYDRAMNIOS AND MEDICAL MALPRACTICE
In one tragic case that we worked on, the mother (whose baby was at term) had very low amniotic fluid. Instead of sending the mother to the hospital right away for close observation and prompt delivery, the obstetrician called the hospital with which he was affiliated to have the mother scheduled for delivery. The hospital did not have any openings for 2 days, so the obstetrician scheduled delivery for 2 days out. This obstetrician didn’t bother calling any other hospitals so the baby could receive prompt care, nor did he instruct the mother to go to the ER / labor and delivery unit for close monitoring, treatment and quick delivery. The mother went home, thinking everything was fine, and 2 days later, she arrived to the hospital for her scheduled delivery. At the hospital, the healthcare team noted her very low amniotic fluid from 2 days prior, but made no rush to deliver the baby. There were no measurements of amniotic fluid in the medical records during this hospital stay. The mother was observed by numerous nurses and resident physicians, and nobody paid much attention to the fact that there were often nonreassuring fetal heart tracings. On day 2 of her stay in the hospital, the team decided to give her an amniofusion after reading the note about her low amniotic fluid from a few days earlier. Still, there were no plans for delivery. When the fetal heart rate patterns became ominous, the obstetrical team finally decided to deliver the baby. Sadly, the baby had been deprived oxygen for too long and was diagnosed with hypoxic ischemic encephalopathy and seizures shortly after birth. He was then diagnosed with severe cerebral palsy.
THE BIRTH INJURY ATTORNEYS AT GREWAL LAW ARE HERE TO HELP
If you think your baby was affected my mismanaged oligohydramnios, and / or your baby experienced oxygen deprivation, a traumatic birth, a brain bleed, delayed delivery, or a delayed emergency C-section - or if your baby’s care was mismanaged after birth in the NICU - please contact our team of experienced birth injury attorneys. The medical malpractice team at Grewal Law is comprised of attorneys and healthcare professionals, including an on-site physician, registered nurse, pharmacist, paramedic, and respiratory therapist. We also work with the best consultants and experts from around the country. Our attorneys are licensed in Michigan, Florida and Arizona and we help victims of medical malpractice and birth trauma throughout the country.
If your baby was diagnosed with HIE, seizures, cerebral palsy, motor disorders, periventricular leukomalacia (PVL), hydrocephalus, intellectual disabilities, or developmental delays, or if you experienced problems during delivery or shortly before or after birth, please call us. Our medical malpractice attorneys and medical staff are available to speak with you 24/7.