This list of terms is not exhaustive, but are commonly used in expert witness reports, letters of claim, letters of response, and medical notes. Not included are conditions of pregnancy and birth, which are unlikely to relate to negligence and birth injury.
Medical Terms – Post Delivery
When you are reviewing your medical notes, or trying to make sense of the expert witness reports, there are a lot of medical words you may not be familiar with.
Therefore, I have put together a summary of some of the words you may see, and a brief explanation of their meaning.
This section deals with post delivery labour and the others with pregnancy, and labour.
This section deals only with terms/words likely to be used with regard to negligence and are not extensive regarding the entirety of pregnancy. To add these would make the list too long.
If you have further questions relating to the terms used in any reports you receive, the person to ask is the solicitor dealing with your case.
Acidotic
A condition where the blood gas measures the PH of the blood and can indicate an acute loss of oxygen, particularly around the time of birth, causing the blood to be more acidic than it should be. The lower the PH the longer the lack of oxygen has gone on for.
Apgar score
A system of evaluating the condition of the baby at birth. More information below…
Arterial blood gases/venous blood gases (AGB/VBG)
A means of measuring the baby’s blood for levels of oxygen and PH (how acid or alkaline it is) Other components are also measured.
Asphyxia (acute and chronic) also referred to as Hypoxia
Loss of oxygen (blood supply) in this case to the baby. Can be acute, as in a very sudden and severe loss of oxygen or present as chronic, where the loss of blood supply is intermittent and shows a different pattern of brain injury.
Basal ganglia
The area of the brain that controls smooth movement and motor control among other functions. It is deep in the brain and is the area that will initially be affected by an acute loss of oxygen. Children with basal ganglia damage will often have dyskinetic cerebral palsy, although less severe injury may have fewer affects.
Brachial plexus injury/ brachial palsy
An injury to the group of nerves that supplies the arms and hands often associated with shoulder dystocia or a difficult birth of a large baby
Cerebral bleed
Some bleeding inside the skull and in areas on and around the brain. There can be many different causes.
Cerebral palsy
An umbrella term to describe a group of movement disorders, usually caused by some kind of brain injury. The type and timing of the injury will often dictate what type of cerebral palsy develops.
Diplegic
Mostly affecting the legs, with other parts of the body less affected or unaffected.
Dystonia
An abnormal movement pattern that makes it very difficult to perform smooth, accurate movements. It can be very disabling and is a feature of HIE and basal ganglia damage in many cases.
Facial nerve injury
Can be caused by pressure on the baby’s face during a poor instrumental delivery.
Fracture of the clavicle or collarbone
Such injuries can be caused by a large baby, small pelvis, difficult or poorly managed birth.
Group Strep B (GSB) infection
An infection by a bacteria that can be passed on to the baby if it is born by the vaginal route. The bacteria lives harmlessly in a large number of the population, but can affect the newborn, causing a severe infection/sepsis. There are warning signs of infection which a competent midwife or doctor should recognise.
Hypoglycaemia
A condition of the newborn which must be checked for and treated. Untreated and severe, hypoglycaemia can cause brain damage.
Hypoxic
Deprived of oxygen from various causes.
Hypoxic ischemic encephalopathy (HIE)
HIE is also called perinatal asphyxia. HIE is caused by loss of oxygen to the brain usually around the time of birth. This causes the brain cells to become damaged, which in turn damages surrounding cells. Therapeutic cooling is aimed at slowing down this damaging process. More information below…
Hemiplegia
Weakness on one side of the body, usually caused by a stroke
Hypothermic treatment (cooling)
An artificial lowering of the body and head temperature, in an attempt to slow down the cumulative effect of the brain injury on the rest of the brain.
Hydrocephalus
A build up of fluid (cerebrospinal fluid) in the brain which, if left untreated, causes brain damage. There are several causes, one of which is HIE and brain injury following a traumatic birth.
A VP Shunt is inserted which drains off the excess fluid in most cases.
Hypotonia
Lethargy and extreme sleepiness
Intubated
The baby has a breathing tube inserted to assist with breathing and is then placed on a mechanical ventilator.
Kernicterus, infant jaundice
A very serious condition of newborns where the level of bilirubin in the blood causes jaundice. It can damage the brain, so it is important to monitor and treat.
Magnetic resonance imaging (MRI)
Is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body, especially of the brain in birth injury cases. The MRI scan can also pick up on when the loss of oxygen occurred as it will affect different areas of the brain in different scenarios. An expert radiologist will be able to determine when the injury occurred.
Maternal hypertension/hypotension
Poorly controlled high blood pressure (hypertension) or low blood pressure (hypotension) with a failure to monitor blood pressure or failure to treat, can have serious effects on the mother and the baby.
Meconium aspiration syndrome
Meconium is dark green fecal matter found in the intestines of a fetus. Around the time of birth the baby can become distressed and pass this meconium into the amniotic fluid or around itself and inhale the meconium. This can cause severe illness post delivery and needs careful treatment and monitoring. There are signs a competent midwife or doctor should recognise.
Neonatal stroke
Strokes caused by blood clots or bleeds into the brain, can cause damage to one side of the brain resulting in hemiplegia (weakness on one side of the body). They can occur naturally or be a result of negligence.
Periventricular leukomalacia (PVL)
A condition of the brain tissue near the ventricles. This damage most often occurs with prematurity but there can be other causes
Quadriplegic
Having all four limbs affected.
Resuscitation
Use of various means to resuscitate the baby. It can be mechanical ventilation on a breathing machine, fluid, and cardiac massage, to restart or maintain the heart rate.
Sepsis
An overwhelming infection which needs urgent identification and treatment by antibiotics.
Seizures
Abnormal brain activity that causes the baby to have epileptic fits. When occurring after birth this is usually a sign of brain injury.
Skull fracture of the baby
Poor use of instruments can cause skull fractures of the baby.
Umbilical cord compression
This can occur in the second stage of labour, most often when the cord becomes trapped between the pelvis and the baby’s head. At each contraction the baby is stressed more than would be normal and can present as an emergency. There are other causes of cord compression.
Ultrasound Scan (USS)
Usually done on the head, and it will pick out bleeds. It is not as detailed as an MRI.
Ventouse
A method of helping the baby exit the birth canal.
