Can my child have a birth asphyxia case in Kingston, New Yorkeven if he/she does not meet all four of the ACOG factors for brain damage caused by lack of oxygen at birth?

The classic birth asphyxia case meets the four ACOG criteria for brain damage caused by lack of oxygen at birth: (1) Apgars of 5 or lower at one minute, five minutes and ten minutes after delivery; (2) pH level of the blood lower than 7.0; (3) multiple organ dysfunction, such as low functioning kidneys, liver, heart and/or brain; and (4) evidence of brain damage on imaging studies, such as a CT scan or MRI of the brain.  If your baby meets these ACOG criteria, there is no question that the lack of oxygen around the time of the birth caused the brain damage.

However, the question is whether a birth asphyxia case may have merit in the absence of some of the ACOG factors. The answer is "YES".  Some kinds of birth asphyxia cases do not involve the classic partial, prolonged deprivation of oxygen in utero that is most common for hypoxic ischemic encephalopathy ("HIE") cases; instead, some kinds of birth involve a sudden, complete deprivation of oxygen in utero that shuts off oxygen and nutrients to the baby almost immediately.  The best example is a baby who sustains brain damage as the result of a uterine rupture or placental previa.

When the mother's uterus ruptures, the baby is expelled forcefully out of the uterus and no longer has the placenta to deliver its oxgen and food supply. When this occurs, the baby has no oxygen supply and must be delivered immediately by emergency cesarean section. Otherwise, the baby will die or sustain brain damage.  In this kind of delivery, where there is an acute, total deprivation of oxygen and nutrients to the baby in utero, it is common that the baby would not meet all four of the ACOG criteria for brain damage caused by birth asphyxia. The baby would likely have low Apgar scores (normal Apgar scores are 7 and above), but he/she would not have an abnormal pH level or multiple organ dysfunction.

In cases of an acute, total deprivation of oxygen to the baby, such as with a uterine rupture or placental previa, there is not enough time for the deprivation of oxygen to cause multiple organ dysfunction or abnormal levels of acid (pH) in the blood.  The answer is "YES" it is possible to have a birth asphyxia case without meeting all four of the ACOG factors for brain damage caused by lack of oxygen at birth.