Information about the causes cerebral palsy
Cerebral palsy is caused by an injury or abnormality in the brain. It is sometimes, but not always, a birth injury.
Cerebral palsy can arise from many potential sources including:
- the failure of the brain to develop properly during pregnancy
- injury to the brain during pregnancy resulting from illness such as maternal high blood pressure or rubella
- lack of oxygen to the baby's brain during labour or delivery leading to hypoxic ischaemic encephalopathy
- injury or illness in the neonatal period
Sometimes a brain injury causing cerebral palsy can result from medical negligence.
Cerebral palsy caused by medical negligence
Failure to recognise or treat maternal or fetal illness
Some maternal illnesses can lead to brain injury in the baby if they are not diagnosed or treated appropriately. Hypertension (high blood pressure) can cause pre-eclampsia. The symptoms of pre-eclampsia include headaches and blurred vision. As well as being very dangerous for the mother, pre-eclampsia can lead to premature delivery, leading to brain injury.
If a pregnant woman catches rubella during the first 10 weeks of pregnancy there is a 90% chance of severe brain injury to the unborn child. The risk declines with time and brain injury from maternal rubella is rare after 16 weeks. Medical negligence claims can arise from failure to perform a blood test for immunity to rubella early in pregnancy or failing to act on the result of the test.
Failure to act on signs of fetal distress to leading to a delay in delivery
Sometimes cerebral palsy is a birth injury caused by a delay in delivering a child. Fetal wellbeing can be monitored during labour in a variety of ways. A cardiotochograph (CTG) measures fetal heart rate and maternal contractions. A midwife or obstetrician looks for certain features on the trace which are indicative of a healthy fetus. These include:
- heart rate in the normal range
- good baseline variability
- accelerations in the heart rate
- decelerations which coincide with contractions
Potentially worrying signs include a heart rate higher (tachycardia) or lower (bradycardia) than the normal range, absence of baseline variability and late or variable decelerations. These may suggest that the fetus is being deprived of oxygen which causes brain damage if oxygen supply is not restored. Sometimes further information can be gathered by taking a fetal blood sample. This measures the acidity of the fetal blood and can detect fetal acidosis - an indication that the fetus is at risk of brain injury.
Other signs of fetal distress include the presence of meconium in the amniotic fluid and decreased fetal movements felt by the mother.
The midwife or obstetrician needs to take into account fetal wellbeing and progress in the labour when deciding whether to deliver the baby by caesarean section, forceps, ventouse or simply by relying on maternal effort. Delaying the decision to deliver when there is evidence of fetal distress is often a cause of clinical negligence claims because the longer the period of fetal distress, the more likely a brain injury.
Failure to diagnose illness in the neonatal period
Likewise, in the newborn period the paediatric or midwifery staff may provide substandard care during the process of resuscitation or the recognition of early illness - for example infection, fitting, neonatal hypoglycaemia (low blood sugar) or hyperbilirubinemia leading to kernicterus.
Please download our guide for individuals and families seeking compensation for cerebral palsy.
Making a cerebral palsy claim
For free, expert advice on making a cerebral palsy claim call us free on 0800 0382 382. If you want to provide some details to us in advance, why not let us assess your claim now.
