Symptoms of HIE

In the previous section, we talked about the Causes of Hypoxic-Ischemic Encephalopathy, or HIE. In this section, we will turn to a discussion of the main symptoms of HIE, including the importance of monitoring for fetal distress signals.

This information has been compiled from government sources, medical sources, and from consulting with experts on HIE.

Read on to learn more about the symptoms of HIE.

What are the Symptoms of HIE During Pregnancy?

One of the biggest symptoms of HIE during pregnancy involves fetal distress signals. These signals will usually be picked up by medical professionals during ultrasounds at virtually any trimester of pregnancy. A fetal distress signal is simply a movement or abnormal heart rate that a doctor can pick up on and treat accordingly.

Other signs and symptoms that doctors should take note of during pregnancy, especially a high-risk pregnancy, include:

• High blood pressure in the mother
• Unusual contraction patterns
• Little movement from the baby
• Extreme cramping in the mother, which usually targets the back
• Excessive vaginal bleeding
• Weight fluctuations that are extreme in the mother

The risk factors involved in a high-risk pregnancy vary. Older women who are pregnant could consider their pregnancy high-risk. Women who have had previous birth complications or C-sections could also have high-risk pregnancies.

In the case of a high-risk pregnancy, a doctor will usually take special care to monitor both mother and baby throughout the entirety of the pregnancy.

It’s also worth noting that placental problems, such as placental abruption and placental insufficiency, can occur during pregnancy and during the birthing process. This condition involves issues with the placenta dislodging from the uterine wall or a malformation of the placenta entirely. Again, in some cases, doctors may be able to pick up on this condition before it becomes a problem.

What are the Symptoms of HIE During and Shortly After Birth?

During delivery, brain injuries can occur as a result of various complications. As we discussed in our section on the causes of HIE, Uterine rupture, which is common with mothers who previously had a C-section, can create an oxygen depriving environment for a baby. Typically, an emergency C-section will be performed to restore blood flow and oxygen to the baby.

Umbilical cord compression is another common scenario that could result in a lack of oxygen in a child’s brain cells. During delivery, the umbilical cord may become lodged between the baby and the pelvic wall of the mother. This temporarily cuts off oxygen to the child, which could result in HIE or another brain injury.

Some signs and symptoms of HIE during this period include:

• Premature birth
• Organ damage or failure
• Very acidic umbilical cord blood (also known as acidemia)
• Seizures
• Comatose state
• Unusually responses to light or lack thereof
• Feeding problems
• Extreme lethargy
• Extreme alertness
• Difficulties breathing and respiratory problems
• Noticeably low muscle tone (also known as hypotonia)
• A very low APGAR score at approximately five minutes or more (we’ll discuss this more in the next section)

In the event of a failed APGAR score or noticeable presence of these symptoms, a medical professional may induce therapeutic hypothermia. This is the act of putting a newborn in a cold environment for the purpose of halting brain cell death and toxin release.

What is the APGAR Score?

APGAR stands for Appearance, Pulse, Grimace, Activity, and Respiration. This test is usually performed right after birth, regardless if complications were present, to evaluate the condition of the newborn.

The APGAR score takes into consideration paleness, heart rate, reflex responsiveness, overall muscle tone, and breathing ability. Babies with HIE may exhibit pale or bluish skin, have a low heart rate and lack reflexes when tested. Some babies with HIE may also have little muscle tone and have problems breathing or crying after birth.

A very low APGAR score that does not improve in five minutes may lead to a diagnosis of HIE or possibly another birth injury condition. Unfortunately, given the subjectivity involved in the APGAR scoring system, a child with HIE may not be detected through applying this test. The APGAR Score may be used along with the Sarnat Scale.

What are the Symptoms of HIE During Childhood?

Unfortunately, if an HIE diagnosis is not found within 24 hours of birth or suspicion of a brain injury is not followed up on, a child’s HIE may not be diagnosed until later in life. Because of the nature of HIE, major symptoms may not be very obvious immediately after birth.

Signs of HIE in infants and children include:

• Chronic seizures or epilepsy
• Motor skills are seriously impaired
• Developmental delays and an inability to reach developmental goals
• Growth problems
• Impairments in hearing and seeing
• Trouble crawling, walking, and moving in general

Cerebral Palsy may be caused by HIE in some cases. Cerebral palsy can be diagnosed later on in development and treated accordingly.