Category Archives: Causes of Cerebral Palsy

Placental Abruption

By Stacey Bucklin
CP Family Network Editor

View similar stories.

Placental abruption is the separation, either partially or completely, of the placenta from the uterine wall before delivery. Although this condition is relatively rare, occurring in 1 out of every 100 pregnancies, the premature detachment of the placenta can have serious health consequences for a mother and her unborn child, including the risk of cerebral palsy.

 

Symptoms

Placental abruption is an extremely serious condition that most commonly occurs during the last few months of gestation, although it can occur any time after the 20th week of a woman’s pregnancy. If you experience these symptoms, contact your doctor or go to the emergency room immediately:

  • Back pain
  • Abdominal pain
  • Vaginal bleeding
  • Frequent uterine contractions
  • Continuous uterine contractions (no relaxation in between)

It is not possible to diagnose the severity of placental abruption by the amount of bleeding from the vagina. Blood may be trapped between the placenta and wall of the uterus, where it is prevented from exiting the body. Any vaginal bleeding during pregnancy should be brought to your doctor’s attention immediately.

 

Diagnosis

Diagnosing placental abruption may be difficult at first. Doctor’s will make a diagnosis based on a physical exam, a medical history, and a process of elimination.

 

Ultrasound

Doctors may conduct an ultrasound in order to see if the placenta has separated from the uterine wall. However, this test is only successful in detecting about 50% of placental abruptions and a negative test does not necessarily mean you are in the clear.

 

Fetal Monitoring

Your doctor should attach a fetal heart monitor to check your baby’s heart rate and check for signs of fetal distress. Fetal heart monitors can also be used to track contractions of the uterus.

 

Test for Anemia

If you suspect you are experiencing a placental abruption, you should be checked for anemia. A woman experiencing placental abruption can become anemic due to excessive blood loss.

 

Risk to Fetus

The placenta nourishes a growing fetus. If it is compromised, such as in placental abruption, the unborn baby may be deprived of oxygen. This can cause stillbirths, premature births, or future growth problems. Oxygen deprivation can also cause brain damage, including cerebral palsy.

When a baby’s brain is deprived of oxygen during pregnancy or birth, parts of the brain may begin to die. This sort of brain damage can result in developmental problems, motor skill issues, and other symptoms of cerebral palsy later in life.

 

Treatment

Placental abruption is not typically fatal to a mother, although it can be for her unborn child. Doctors will determine an appropriate course of action based on the following factors:

  • Severity of the abruption
  • Impact on the fetus (is the baby in distress?)
  • Proximity to the baby’s due date

If your placenta has separated from the wall of your uterus, your doctor will monitor you for shock and will monitor your baby for signs of distress, including a decline in fetal heart rate. Mild abruptions may heal on their own. You may also receive IV fluids or blood transfusions to replace blood loss.

In some cases, the mother will be kept at the hospital for close observation. Depending on how far along the pregnancy is, vaginal delivery may be a safe option. However, emergency Cesarean sections are often required.

 

Prevention

In many cases, there is little you can do to prevent placental abruption. However, proper prenatal care is the first step in preventing a wide variety of pregnancy complications. Avoid drinking alcohol, smoking, or using recreational drugs during your pregnancy.  Alert your doctor to preexisting conditions such as high blood pressure and diabetes and be sure to monitor these regularly.

Placental abruption may also be caused by trauma such as a car accident or fall. If you experience any sort of trauma during your pregnancy, notify your doctor as soon as possible.

 

Resources

U.S. National Library of Medicine – Placental Abruption

Mayo Clinic – Placental Abruption

March of Dimes – Pregnancy Complications

Web MD – Health & Pregnancy

 

Join Our Family

Sign up for our free e-newsletter for more blogs, articles, and news about CP kids and their families.

Pitocin and Its Ties to Cerebral Palsy

By Stacey Bucklin
CP Family Network Editor

View similar stories.

Pitocin is the synthetic version of a naturally occurring hormone called oxytocin that is produced by a woman’s body during labor and delivery. It is used to induce labor or to speed up (augment) natural labor. It may also be administered to help a mother expel the placenta after delivery and to help get a mother’s milk flowing for breastfeeding.

Although commonly used, Pitocin can cause complications which can lead to brain injury and cerebral palsy in unborn children and newborns. Expectant parents should carefully consider the risks and benefits of Pitocin and discuss their options with their doctor before they arrive in the delivery room.

 

When Should Pitocin be Considered

The American College of Obstetricians and Gynecologists sanctions the use of Pitocin “to induce labor for convenience once a woman has reached her 39th week of pregnancy and her cervix is ripe.” However, not all doctors agree with this sanction and will only induce labor under certain conditions.

A doctor may consider using Pitocin to induce delivery when:

  • A woman is approaching her 42nd week of pregnancy
  • Labor needs to be augmented or sped up, such as when a woman’s water has broken but contractions have not yet begun
  • An epidural has slowed down the labor process

 

Risks of Pitocin

Pitocin is administered through an IV. Typically, the dose is slowly increased until the doctor is satisfied that the laboring mother has progressed sufficiently for childbirth. However, this does not perfectly mimic the natural production of hormones in a woman’s body during labor and may cause complications.

Certain pre-existing conditions or medical histories can cause adverse reactions when Pitocin is used. Women with any of the following risk factors should notify their doctor before using the hormone:

  • Genital herpes
  • Diabetes
  • High blood pressure
  • Heart rhythm disorder
  • History of cervical cancer
  • Severe uterine infection
  • Previous surgeries (including a C-section) on the cervix or uterus
  • History of difficult labor because of a small pelvis
  • Pregnancy that is less than 37 weeks
  • 5 or more previous pregnancies

The unborn child should be continuously monitored using fetal heart monitoring equipment once labor has been induced. Contractions induced by Pitocin differ from natural contractions in their intensity and duration. Induced contractions may decrease uterine blood flow more than would occur during natural contractions. Since the body may not be ready to deliver, other complications may arise that could increase the odds of needing an emergency Caesarean section.

There are other risks to both baby and mother when Pitocin is used including:

 

Risks to Mother:

  • Increased pain causing need for epidural
  • Tetanic (very strong) contractions
  • Premature separation of the placenta
  • Rupture of the uterus
  • Laceration of the cervix
  • Post-birth hemorrhage

 

Risks to Baby:

  • Fetal asphyxia
  • Neonatal hypoxia
  • Physical injury
  • Prematurity if the due date is not accurate

Sometimes, doctors or mothers will request the use of Pitocin to speed up processes that would occur naturally if given time. In these cases, both parties should carefully consider the risks of using the hormone. It may be wiser to allow a woman’s body to function at its own pace rather than putting the unborn child at risk for the sake of convenience.

 

Pitocin’s Link to Cerebral Palsy

When Pitocin is used improperly or when doctors ignore or misread signs of fetal distress, the baby may suffer preventable birth injuries, including those that cause cerebral palsy. When oxygen supply or blood flow to an unborn child is compromised, fetal asphyxia or neonatal hypoxia can result. Both of these conditions have been linked to the development of cerebral palsy. Physical injuries such as placental abruption and rupture of the uterus may also result in cerebral palsy, brain damage or death to the infant.

 

Making the Decision to Induce

Expecting mothers should discuss all possible birth scenarios with their doctor before their due date. Discuss the risks and benefits of induced labor and develop a birth plan that you, your loved ones, and your medical providers can agree upon. It is much easier to gather information and make educated decisions before your judgment is clouded by adrenalin, medications, and unexpected circumstances.

There are many, many cases of successful deliveries in which Pitocin was used. Unfortunately, there are also many stories of babies who suffered unnecessary, sometimes permanent, injuries because doctors misused the hormone or misread the signs of fetal distress it caused.

 

Resources

Pitocin & its Ties to Cerebral Palsy
Inducing Labor with Pitocin: Making the Choice
Drugs.com – Pitocin

 

Join Our Family

Sign up for our free e-newsletter for more blogs, articles, and news about CP kids and their families.

Advice to Expecting Parents about Assisted Delivery Using Vacuum Extraction

By Giles Manley, M.D., J.D.

Medical Director, Cerebral Palsy Family Network

View similar stories.

Expectant parents should discuss vacuum extraction and its link to cerebral palsy prior to delivery.When a mother is unable to deliver a child on her own, assistive equipment may be used to help speed the birthing process. Because the need for vacuum extraction (VE) is always a possibility during childbirth, parents need to be aware of what it entails and what questions to ask of their doctor.

Vacuum extraction is a mechanical means of helping a baby move down the birth canal. It involves attaching a suction cup to scalp of the baby, while it’s still in the womb, and then pulling gently. The need may arise if labor has gone on too long, the mother is exhausted or fetal monitoring shows the baby isn’t getting enough oxygen and needs to be born more quickly.

Because a baby’s head is fragile, the suction cup can cause minor injuries, such as bruising or cuts, or even pull the head out of shape. These conditions usually clear up in a month or so. More serious injuries can also occur, including subgaleal hemorrhage (bleeding between the scalp and the skull), direct trauma to the skull or brain, or severe shoulder injury.

 

Questions Parents Should Ask Their Doctor

A couple’s obstetrician should go over the topic of vacuum extraction prior to delivery. At this time, the parents should ask about the OB’s experience with deliveries that involve vacuum equipment or forceps. In experienced hands, forceps are safer if the station of the baby is not very low. Parents should ask to be informed as soon as possible about the possibility of such a procedure becoming necessary.

Should the need for vacuum-assisted delivery arise, the doctor should review the pros and cons of the procedure and why he or she thinks it is necessary. At this time parents should:

  • Ask “What station is my baby?” Unless at least plus two, and preferably plus three, a vacuum should not be used.
  • Ask that if the procedure isn’t effective within 2-3 pulls, mechanical extraction be discontinued in favor of a C-section.
  • Request that the hospital prepare for a C-section immediately, in case it is needed.
  • Make sure that the child is evaluated at birth and re-evaluated later for signs of injury.

By knowing what questions to ask about the procedure, expectant parents can better advocate for their child. As a practicing obstetrician for 20 years, I know that attentive parents often have the effect of making doctors and nurses more attentive as well.

 

Join Our Family

Sign up for our free e-newsletter for more blogs, articles, and news about CP kids and their families.

 

FREE MEDICAL AND LEGAL RESOURCES

The Cerebral Palsy Survival Guide is a free, state-specific resource list for everything from everyday activities to emergency situations.

BI-WEEKLY E-NEWSLETTER SIGN-UP

Sign up for our e-newsletter to receive the latest in CP news, resources and

LATEST BLOG POSTS

1700 Miles in 28 Days: Father and Son Run for CP Awareness

By: Clint DeRoze Via: Valley News Live 1700 miles in 28 days. That’s the goal of Shaun Evans and his son Shamus. Shamus was born with cerebral palsy, making it…

Read more

Delhi Kid with Cerebral Palsy Inspires Iron Man Style Suit for the Disabled

By Anirudh Bhattacharyya Via Hindustan Times Photo Courtesy: Trexo Robotics A Delhi child with cerebral palsy inspired the development of the first commercial exoskeleton for children with disabilities by two…

Read more