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Hypoxic Ischemic Encephalopathy (HIE)

What is hypoxic ischemic encephalopathy?

Hypoxic ischemic encephalopathy (HIE) is a form of brain injury caused by the brain being deprived of oxygen during the fetal or neonatal stages of birth, HIE is also sometimes referred to as intrapartum asphyxia. HIE is a leading cause of death and severe impairments among infants.

What are the symptoms of hypoxic ischemic encephalopathy?

HIE can be responsible for a range of impairments including epilepsy, developmental delays, motor impairment, neurodevelopmental delays, and cognitive impairments.

What causes hypoxic ischemic encephalopathy?

HIE is cause by oxygen failing to reach the brain – a form of asphyxia. It is most common in full-term infants, but can affect premature infants as well. Factors that increase the risk of asphyxia include:
  • Acute maternal hypotension
  • Blood containing less oxygen due to poorly functioning lungs
  • Cardiac complications
  • Injury from cephalopelvic disproportion
  • Injury from umbilical cord complications
  • Impaired blood flow to the brain during birth
  • Interruption in breathing or poor oxygen supply
  • Intrapartum hemorrhage
  • Medical negligence
  • Prolapsed cord
  • Placental abruption
  • Pressure to the cranium that changes it shape
  • Ruptured vasa previa
  • Stress of labor and delivery
  • Trauma
  • Uterine rupture

How is hypoxic ischemic encephalopathy diagnosed?

Doctors will test for HIE if elements of the birth lead them to suspect a trauma or if there is a significant risk factor identified. Neuroimaging such as MRI are the most useful tools to confirm diagnosis. Impaired motor function, delays in development, and delayed growth may be useful diagnostic references if a diagnosis is not initially reached.

What are the treatments for hypoxic ischemic encephalopathy?

Treatment usually focuses on helping an affected child adapt to symptoms. Unfortunately, damage from asphyxia tends to be permanent, and can even cause further damage after oxygen has returned to the brain. To prevent further damage, children suspected of HIE should be carefully monitored to maintain normal blood glucose, and blood pressure. Measures should also be taken to prevent or control seizures, and prevent cerebral edema. 

Where can I find out more about hypoxic ischemic encephalopathy?

Hypoxic Ischemic Encephalopathy (HIE) Articles