Birth Injury Glossary

At ABC Law Centers: Birth Injury Lawyers, we believe that improving the lives of birth injury victims begins with education and access to information. Throughout this page, you’ll find dozens of terms related to both the medical and legal aspects of birth injury.

Do you have any legal questions about the content or terms on this page? Reach out to our birth injury attorneys anytime.

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A

Acupuncture: An alternative form of therapy in which medical professionals insert needles into specific locations on the body to manipulate energy flow. Some individuals with cerebral palsy or neurological disorders complement therapy regimens with acupuncture.

See also: Alternative Therapy; Cerebral Palsy; Complementary Therapy; Therapy

Acute Profound Asphyxia: A term describing the extent of oxygen deprivation in cases of hypoxic ischemic encephalopathy (HIE). Commonly referred to as acute near total asphyxia, this form of hypoxic ischemic encephalopathy (HIE) is caused by prolonged, complete periods of fetal oxygen deprivation usually lasting under 30 minutes. Known causes of acute profound asphyxia include emergency pregnancy and delivery complications such as uterine rupture, umbilical cord prolapse, placental abruption and terminal bradycardia from umbilical cord compression.

See also: Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Mixed Injury Pattern Asphyxia; Neonatal Encephalopathy (NE); Partial Prolonged Asphyxia

Adaptive Equipment: Devices used to increase functional ability in disabled or impaired individuals. Adaptive equipment allows disabled people to more easily complete tasks of daily living.

See also: Assistive Technology; Augmentative and Alternative Communication (AAC)

Adjusted Age: See Corrected Age.

Alternative Therapy: A grouping of therapies, practices and procedures that include traditional and new healing methods.

See also: Complementary Therapy

Americans with Disabilities Act: The Americans with Disabilities Act (ADA) is a civil rights law that passed in 1990. This law makes it illegal to discriminate against people with disabilities in all areas of public life (including in employment, education, transportation, and public facilities). This law seeks to ensure that people with disabilities have the same rights and opportunities as those without disabilities.

Amniocentesis: A prenatal amniotic fluid test in which a small portion of the fluid is removed by inserting a fine needle through the abdomen. Amniotic fluid is analyzed by a laboratory to determine the presence of birth defects, lung maturity, infection or other relevant medical findings.

See also: Amniotic Fluid

Amniotic Fluid: The liquid in the amniotic sac that surrounds the fetus.

See also: Amniocentesis; Polyhydramnios; Oligohydramnios

Amniotic Sac: The fluid-filled sac inside a pregnant woman’s uterus containing and protecting the fetus.

Amniotic Fluid; Amniocentesis

Amniotic Fluid Embolism (AFE): An extremely rare condition that can occur during delivery when the amniotic fluid enters into the mother’s blood stream.

See also: Amniotic Fluid; Amniotic Sac

Anat Baniel Method (ABM): A holistic approach to movement rehabilitation. AMB works to change neural patterns to help people overcome injury, increase strength and flexibility and move beyond the pain of their injuries.

See also: Alternative Therapy; Cerebral Palsy; Complementary Therapy

Anesthesia: Anesthesia is used for labor pain relief. Mothers must give informed consent before anesthesia or pain relief is given. Types of anesthesia include general anesthesia or regional anesthesia (which include spinal anesthesia or epidural anesthesia).

See also: Epidural Anesthesia; General Anesthesia; Regional Anesthesia; Spinal Anesthesia

Animal-Assisted Therapy: Therapy involving animals used to improve physical, cognitive, emotional or behavioral problems.

See also: Equine-Assisted Therapy; Hippotherapy; Recreational Therapy

Anoxia: The complete absence or deficiency of oxygen reaching the tissues. Anoxia is an extreme form of hypoxia. When anoxia occurs in brain tissue, it is known as cerebral anoxia. Anoxic events can occur before or at the time of birth and cause permanent injury.

See also: Anoxic Brain Injury; Cerebral Anoxia; Cerebral Hypoxia; Hypoxia; Hypoxic-Anoxic Injury; Hypoxic Ischemic Encephalopathy (HIE)

Anoxic Brain Injury: A brain injury resulting from anoxia, a condition in which the brain is completely deprived of oxygen. For instance, cerebral anoxia is a type of anoxic brain injury. Anoxic brain injuries can occur before or at the time of delivery and result in permanent birth injuries and disabilities.

See also: Anoxia; Cerebral Anoxia; Cerebral Hypoxia; Hypoxia; Hypoxic-Anoxic Injury; Hypoxic Ischemic Encephalopathy (HIE)

Antepartum Hemorrhage: Bleeding from the genital tract during the second half of pregnancy.

Antiphospholipid Antibody Syndrome (APS): An autoimmune disorder in which antibodies (proteins that fight infections) attack the phospholipids (fat found in cells and cell membranes). APS can lead to blood clots, stroke, heart attack, kidney damage deep vein thrombosis and pulmonary embolism. It can cause fetal (intrauterine) growth restriction.

See also: Fetal Growth Restriction (FGR); Intrauterine Growth Restriction (IUGR)

Apgar Score: The very first test a baby will have directly after birth. Apgar tests quickly evaluate a newborn’s overall health in the first few minutes of life. Heart rate, breathing, grimace (responsiveness), activity (muscle tone) and appearance (skin color) are all measured and tested.

See also: Birth Injury; Birth Trauma; Diagnosis

Apnea: A temporary suspension of breathing. It is referred to as infant apnea with newborns and sleep apnea in adults.

See also: Neonatal Breathing Problems in Term Babies; Neonatal Breathing Problems of Prematurity

Apraxia: A neurological condition characterized by the inability to move with purpose, even though the muscles are physically able. Orofacial apraxia is an inability to move facial muscles. Certain forms of apraxia only involve the arms and legs. Apraxia of speech makes it difficult or impossible to move the lips and tongue to speak.

See also: Speech Deficits

Art Therapy: Therapy involving the arts. Examples include music therapy, visual art therapy and dance therapy.

See also: Alternative Therapy; Complementary Therapy; Recreational Therapy; Therapy

Asphyxia: An emergency condition characterized by severe oxygen deprivation–particularly in the womb–causing death, disability or permanent injury.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy (NE)

Assistive Technology: Any device used to assist disabled children with tasks of daily living.

See also: Adaptive Equipment; Augmentative and Alternative Communication (AAC)

Ataxia: A neurological disorder caused by dysfunction of the nervous system that affects the coordination of muscle movements.

See also: Ataxic Cerebral Palsy; Cerebral Palsy; Motor Disturbance Classification System

Ataxic Cerebral Palsy: A type of cerebral palsy based on the Motor Disturbance Classification System. Ataxic cerebral palsy is characterized by hypotonia (decreased muscle tone) and tremors. Controlled movements and fine motor skills are affected, which include posture and balance (particularly while walking) and movements such as writing, typing or using scissors.

See also: Ataxia; Cerebral Palsy; Fine Motor Skills; Hypotonia; Motor Disturbance Classification System; Tremor

Athetosis: A subclassification of dyskinetic cerebral palsy based on the nature of dyskinetic movement. Abnormal muscle contractions that cause slow, involuntary slow writhing movements.

See also: Cerebral Palsy; Chorea; Dyskinetic Cerebral Palsy; Dystonia; Motor Disturbance Classification System

Augmentative and Alternative Communication (AAC): Any communication method used to assist or replace verbal or written language for people with communication, speech, language or comprehension impairments.

See also: Adaptive Equipment; Assistive Technology

B

Baclofen: A drug used to treat spasticity. It relaxes skeletal muscles and depresses the nervous system.

See also: Baclofen Pump; Cerebral Palsy; Spastic Cerebral Palsy; Spasticity

Baclofen Pump: Baclofen, a drug used to treat spasticity, is largely taken orally. However, in Intrathecal baclofen therapy (ITB) for severe spasticity, baclofen pumps are used to deliver the medicine to the patient’s spinal fluid. The pump, which is about the size of a hockey puck, is inserted under the skin near the abdomen.

See also: Baclofen; Cerebral Palsy; Spastic Cerebral Palsy; Spasticity

Bacterial Vaginosis (BV): A common bacterial infection of the vagina resulting from an imbalance of a woman’s naturally occurring bacteria. One in four women experience BV during pregnancy, and many experience recurring infections. Gardnerella vaginalis is a bacterium associated with BV. Without treatment, this bacterium can cause premature birth, premature rupture of the membranes (PROM) and miscarriage with resultant cerebral palsy, fetal death, infant brain damage and related injuries.

See also: Maternal Infections

Basal Ganglia (Basal Nuclei): A part of the brain that is comprised of subcortical nuclei in the forebrain. These subcortical nuclei are essential for normal brain function. Behavioral and neurological disorders often result from damage to this part of the cerebrum. Examples include cerebral palsy (primarily dyskinetic cerebral palsy), dystonia, movement disorders, hemiballismus, and obsessive-compulsive disorders.

See also: Cerebral Palsy; Dyskinetic Cerebral Palsy; Dystonia

Betamethasone: A steroid given to the mother to help prevent birth injuries in preterm babies.

See also: Premature Birth

Bilateral Cerebral Palsy: Cerebral palsy affecting both sides of the brain.

See also: diplegia, spastic diplegia, triplegia, spastic triplegia, quadriplegia, spastic quadriplegia, pentaplegia, spastic pentaplegia

Bilirubin: A yellow/orange substance that is found in the bile. When the liver breaks down old red blood cells, bilirubin is produced in the body. Bilirubin tests can be useful in finding out is if a patient is jaundiced. When bilirubin levels are high, a patient may have yellow in the whites of their eyes. High bilirubin levels in newborn babies must be treated promptly to avoid permanent brain injury and disability.

See also: Elevated Bilirubin; Hyperbilirubinemia; Jaundice; Kernicterus

Biophysical Profile: The fetal biophysical profile (FPP) is a noninvasive and simple way to identify whether a fetus’ health is in some way abnormal. This test uses ultrasound to evaluate fetal movement, fetal tone, breathing, and amniotic fluid volume. Sometimes, a fifth section of the test measures fetal heart rate. This test is used as a tool to see whether doctors have to take further action to prevent adverse health effects from occurring.

Birth Asphyxia: A lack of oxygen flow to the brain before, during or directly after birth. Birth asphyxia is very dangerous and can lead to neonatal encephalopathy (NE) and hypoxic ischemic encephalopathy (HIE). Birth asphyxia is another term for intrapartum asphyxia.

See also: Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy (NE)

Birth Injury: Impairment of an infant’s body function or structure due to an injury that occurred during birth. Birth injuries typically refer to those injuries caused by a lack of oxygen to the baby’s brain or a brain infection, while birth trauma refers to those injuries caused by mechanical damage.

See also: Birth Injury Attorney; Birth Trauma

Birth Injury Attorney (Birth Trauma Attorney): A medical malpractice attorney that specifically focuses on cases related to birth injuries and birth trauma.

See also: Birth Injury

Birth Trauma: Injuries inflicted on a baby during prolonged or traumatic labor or delivery. Traumatic birth injuries encompass all injuries to a baby’s tissues and organs, as well as their long-term consequence. Birth trauma is usually thought of as being caused by mechanical damage, such as prolonged labor or use of forceps or vacuum extraction. The term birth injury typically refers to injury caused by a lack of oxygen to the baby’s brain or a brain infection.

See also: Birth Injury; Birth Injury Attorney; Brain Bleed; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Bodywork: Any therapeutic technique involving the manipulation of the human body. Examples include Rolfing, the Alexander Method, Reflexology and massage therapy.

See also: Alternative Therapy; Complementary Therapy; Massage Therapy; Therapy

Botox: Botulinum toxin type B is a bacteria that allows the muscles to weaken or relax. Botox injections can help loosen stiff muscles in patients with cerebral palsy.

See also: Cerebral Palsy

Brachial Plexus Injury (BPI): An injury to the nerves that control the shoulder, hand and fingers due to downward traction on a baby’s head by the medical provider during delivery after shoulder dystocia.

See also: Brachial Plexus Injury (BPI); Erb’s Palsy; Shoulder Dystocia

Bradycardia: A slower than average heart beat, with values under 110 BPM. Fetal bradycardia is very serious and can be caused by hypoxia, or it may be the cause of hypoxia. Bradycardia can lead to hypoxia and hypoxic ischemic encephalopathy if sufficiently prolonged.

See also: Hypoxia; Hypoxic Ischemic Encephalopathy (HIE); Tachycardia

Brain Bleed (Intracranial Hemorrhage): A birth injury that can be caused by trauma, hypoxic ischemic encephalopathy or related to prematurity characterized by bleeding within the skull or brain. Brain bleeds often cause other injuries and disabilities such as cerebral palsy.

See also: Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage; hypoxic ischemic encephalopathy

Brain Damage: Any injury to the brain resulting in loss of function. Some causes of brain damage include oxygen deprivation and trauma.

See also: Cerebral Palsy; Hypoxic Ischemic Encephalopathy (HIE); Periventricular Leukomalacia (PVL)

Brain Injury: Brain injuries are a broad category of damage that occurs in the brain. Injuries have differing levels of severity and impairment associated with them, and can be caused by a multitude of factors. Often, brain injuries are caused by trauma, which can result in seizures, bleeding, cognitive impairment, and epilepsy. Brain injuries can be divided into two categories: primary brain injury and secondary brain injury. Primary brain injury occurs at the time a mechanical force impacts the head, while secondary brain injuries occur as a cascade of events (‘domino effect’) and persists for hours or days after the initial event that caused injury. Secondary brain injury makes the effects of primary brain injury much worse.

See also: Brain Damage

Brain Imaging Tests (Neuroimaging): Techniques that allow medical professionals and researchers to produce images of the structures and activity of the brain and nervous system.

See also: CT Scan; Diagnosis; EEG; Evoked Potential Test; MRI; Ultrasound; PET Scan.

Breech Presentation (Breech Birth): A breech presentation or breech birth occurs when a baby’s feet or buttocks present first during birth, instead of the head.

See also: Face Presentation; Fetal Presentation; Malpresentation (of Fetus); Vertex Presentation

Brow Presentation: Brow presentation is a description of the position in which a baby is delivered. Normally, children are delivered head-first with their chin tucked into their chest. Brow presentation happens when the fetus’ chin is not tucked in to the chest, the neck is extended backwards and the face is the first part to enter the birth canal (rather than the crown of the head). This can stall the fetus’ descent down the birth canal and make delivery difficult. It also increases the likelihood of injury:

C

C-Section (Cesarean Section) Delivery: A surgical procedure in which the baby is delivered through an incision in the mother’s abdomen and uterus. C-section deliveries are usually performed when vaginal delivery poses risks to the mother or child.

See also: Emergency C-Section

Category System for Fetal Heart Monitoring: A heavily criticized system for interpreting fetal heart monitoring defined by the American College of Obstetricians (ACOG). Category 1 is characterized by normal fetal heart rate. Category 2 is characterized by intermediate fetal heart rate that may be indicative of a baby at risk who requires close monitoring and, most likely, intervention. Category 3 is characterized by abnormal fetal heart rate. There is much debate as to whether Category 2 is too broad to define complications with the fetal heart rate that arise during labor and delivery. Many leading experts have recommended that there be a five tier system for evaluating fetal heart monitoring.

See also: Fetal Distress; Fetal Heart Monitoring, Fetal Heart Tracings; Hypoxic Ischemic Encephalopathy (HIE); Improper Fetal Monitoring; Nonstress Test (NST)

Cephalhematoma: See Cephalohematoma.

See also: Brain Bleed; Birth Trauma; Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Cephalohematoma (Cephalhematoma): A form of intracranial hemorrhage in which bleeding occurs between the skull and its covering. Bleeding may begin before birth or within a few hours after birth and may continue anywhere from two weeks to a few months.

See also: Brain Bleed; Birth Trauma; Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Cephalopelvic Disproportion (CPD): A delivery complication in which either the baby’s head is too large to pass through the mother’s pelvis without damage or because the mother’s pelvis is too small to allow the baby’s head to pass.

See also: Birth Trauma

Cerebral Anoxia: A form of hypoxia in which brain tissue is completely deprived of oxygen. Cerebral anoxia is a type of anoxic brain injury. Cerebral anoxia can occur before or at the time of birth and cause permanent injury.

See also: Anoxia; Anoxic Brain Injury; Cerebral Hypoxia; Hypoxia; Hypoxic-Anoxic Injury; Hypoxic Ischemic Encephalopathy (HIE)

Cerebral Edema: Swelling of the brain caused by hypoxic ischemic encephalopathy, trauma, ischemic stroke or inflammation.

See also: Brain Damage

Cerebral Hemorrhage: When a ruptured blood vessel causes bleeding within the brain itself.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Fetal Stroke; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Cerebral Hypoxia: A form of hypoxia in which a shortage of oxygen in the blood (hypoxia) results in oxygen deprivation within the brain. Cerebral hypoxia can occur before or at the time of birth and cause permanent birth injuries and disabilities.

See also: Hypoxia; Hypoxic-Anoxic Injury; Hypoxic Ischemic Encephalopathy (HIE)

Cerebral Infarction: Brain tissue death caused by fetal oxygen deprivation and hypoxic ischemic encephalopathy (HIE).

See also: Hypoxic Ischemic Encephalopathy (HIE); Prothrombotic Coagulation Disorder

Cerebral Palsy (CP): The umbrella term given to a group of non-progressive motor conditions in which brain damage results in the impairment or loss of movement. Because this permanent neurological disorder results from an injury of the developing brain, cerebral palsy is often the result of a birth injury.

Cervical Bleeding: Bleeding that occurs in early pregnancy due to the increased number of blood vessels in the cervical area.

Cervical Cerclage: A procedure in which the cervix is stitched closed to help support the weight of the baby and prevent preterm birth. Cerclages prevent premature birth by reinforcing the cervical muscle. Sometimes, cervixes become too short (25 mm or below) between 14 and 24 gestational age. Cerclages are recommended in these cases and for mothers with histories of preterm delivery.

See also: Incompetent Cervix; Premature Birth

Chorea: A subclassification of dyskinetic cerebral palsy based on the nature of dyskinetic movement. Chorea is characterized by irregular, unpredictable jerking movements. When chorea occurs alongside athetosis, it is known as choreoathetosis.

See also: Athetosis; Cerebral Palsy; Dyskinetic Cerebral Palsy; Dystonia; Motor Disturbance Classification System

Chorioamnionitis (Intra-Amniotic Infection): An inflammation or ascending infection of the fetal membranes usually due to an untreated infection.

See also: Maternal Infections

Chorionic Hematoma: A pool of blood between the chorion, which is a membrane that surrounds the embryo, and the uterine wall. Chorionic hematomas are caused by the separation of the chorion from the uterus.

See also: Hematoma

Chorionic Villi: Chorionic villi develop to maximize surface area contact with maternal blood for nutrient and gas exchange with fetal blood. Inflammation of the chorionic villi surface of the placenta is known as villitis.

See also: Maternal Infections; Villitis

Clindamycin: A prescribed antibiotic used for treating bacterial infections.

See also: Maternal Infections

Clonic Seizures: A classification of neonatal seizures. Contractions and relaxations of a particular muscle, or repetitive jerking of the muscles. Clonic seizures cannot be stopped by restraint. They occur in 25% of all neonatal seizures.

See also: Epilepsy; Seizures

Clonus: Involuntary, rhythmic muscular contractions. Often, clonus is an early sign of cerebral palsy in babies.

See also: Cerebral Palsy

Communication Function Classification System (Classification of Cerebral Palsy): A classification system that organizes cerebral palsy into five levels based on everyday communication performance. The CFCS measures one’s ability to send and receive communication signals.

See also: Cerebral Palsy; Speech Deficits

Complementary Therapy: Alternative therapies that are coupled with traditional methods of healing.

See also: Alternative Therapy

Compressed Umbilical Cord: See Umbilical Cord Compression

See also: Umbilical Cord; Umbilical Cord Compression; Umbilical Cord Prolapse; Nuchal Cord; True Knot; Short Cord

Conductive Education (CE): An educational program designed for individuals with neurological disorders that operates on the theory that motor skill limitations stem from learning limitations. Students are encouraged to set goals, adapt to disability without the aid of equipment or technology, and avoid learned helplessness.

See also: Alternative Therapy; Cerebral Palsy; Complementary Therapy; Therapy

Congenital Heart Disease: The most common birth defect that changes the normal amount of blood flow to the heart. Valve defect, problems with the heart walls or muscles and bad connections to the blood vessels are all possible congenital heart defects.

Contractures: Tightened or shortened muscles, tendons or bodily tissues. Contractures often cause joint stiffness and limited movement, and they are often found in people with cerebral palsy and spastic cerebral palsy.

See also: Cerebral Palsy; Spastic Cerebral Palsy; Spasticity; Tendon Release Surgery

Corrected Age: The adjusted or corrected age of the premature baby is the age of the baby based on the due date. For example, if a baby’s chronological age is 3 months, but he or she was born one month early, the baby is said to have an adjusted age of 2 months.

See also: Premature Birth

Craniosacral Therapy (Cranial-Sacral Therapy; CST): A form of bodywork that targets the body’s craniosacral system to alleviate physical pain and dysfunction.

See also: Alternative Therapy; Bodywork; Complementary Therapy; Therapy

Crawling Reflex: A primitive reflex in which an infant pulls his or her legs under the body and moves them in a crawling motion. Retention of the crawling reflex beyond the first few weeks of life can be a sign of cerebral palsy and developmental disabilities in a baby.

See also: Cerebral Palsy; Primitive Reflexes

CT Scan (Computed Tomography): A brain scanning technique that uses special X-ray tests which produce detailed, cross-sectional images of internal structures of the head and body.

See also: Brain Imaging Tests; Diagnosis; EEG; Evoked Potential Test; MRI; Ultrasound

Cytomegalovirus (CMV): A strain of the herpes virus that is often symptomless.

See also: Encephalitis; Herpes Simplex Virus (HSV) and Related Injury; Maternal Infections; Neonatal Herpes Encephalitis

Cytotec (Misoprostol): A drug used to induce labor in pregnant women. Cytotec ripens the cervix to produce contractions. Misuse of Cytotec is dangerous and often causes fetal oxygen deprivation, birth injuries and permanent disabilities.

See also: Oxytocin; Pitocin

D

Decelerations (Labor and Delivery Decelerations): When the fetal heart rate drops, it is known as deceleration. In labor and delivery, these can be benign (in the case of some early decelerations) or harmful (in the case of late, variable or prolonged decelerations). The harmful decelerations are related to reduced fetal oxygenation, and place the fetus at risk for oxygen deprivation-related injuries.

Delivery Assistance Tools: Instruments used to assist in the vaginal delivery of a baby. Commonly used delivery assistance tools and devices include forceps and vacuum extractors.

See also: Forceps; Vacuum Extractors

Depressed Skull Fractures: Depressed skull fractures occur when the baby’s cranium is crushed inwards towards the brain, forming a depression. They most commonly occur during difficult vaginal deliveries, such as those where cephalopelvic disproportion (CPD) is present, where there is a prolonged labor, or where vacuum extraction or forceps are used during the delivery process.

See also: Cephalopelvic Disproportion (CPD); Birth Trauma; Intracranial Hemorrhages (Brain Bleeds); Linear Skull Fracture; Occipital Osteodiastasis; Skull Fractures (Cranial Fractures)

Developmental Delays: When a child fails to meet mental or physical milestones by the expected period of time.

See also: Cerebral Palsy, Developmental Milestones; Intellectual and Developmental Disabilities (I/DD)

Developmental Milestones: A set of skills that a child should have by a certain age. Walking, crawling and speaking are examples of developmental milestones.

See also: Developmental Delays; Intellectual and Developmental Disabilities (I/DD)

Diagnosis: The identification of a medical condition, illness, injury or other health problem through examination and testing of signs and symptoms.

See also: Apgar Score; Brain Imaging Tests; Sign (Clinical Sign); Symptom

Diazepam: A prescribed medication that is used to treat anxiety, muscle spasms and seizures.

See also: Cerebral Palsy; Epilepsy; Seizures; Spastic Cerebral Palsy; Spasticity

Diparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which limbs on the opposite sides of the body are weakened or paralyzed from neurological damage. For instance, a person with diparesis would have either both legs or both arms affected.

See also: Cerebral Palsy; Limb Involvement Classification System; Diplegia (Diplegic Cerebral Palsy); -paresis

Diplegia (Diplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which limbs on the opposite sides of the body are affected and the legs more affected than the arms.

See also: Cerebral Palsy; Limb Involvement Classification System

Disseminated Intravascular Coagulation (DIC): A rare blood condition in which blood begins to clot excessively, eventually leading to heavy bleeding when all the body’s clotting proteins are used up.

Doppler Flow: An ultrasound that uses sound waves to determine how blood is flowing through the blood vessels. This test is sometimes used to check the flow of blood in the umbilical cord and vessels in the baby’s brain.

See also: Diagnosis; Ultrasound (Ultrasonography)

Double Hemiparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which both sides of the body are weak or partially paralyzed from neurological damage, but one side is more involved.

See also: Cerebral Palsy; Limb Involvement Classification System; Double Hemiplegia (Double Hemiplegic Cerebral Palsy); -paresis

Double Hemiplegia (Hemiplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which both arms and both legs are affected, but one side of the body is more involved.

See also: Cerebral Palsy; Limb Involvement Classification System

Dysarthria: A motor speech disorder characterized by poor articulation and impairment of the muscles used for speech. Dysarthria is caused by neurological injuries and conditions such as cerebral palsy.

See also: Cerebral Palsy; Speech Deficits

Dyskinetic Cerebral Palsy: A type of cerebral palsy based on the Motor Disturbance Classification System. Dyskinetic cerebral palsy is characterized by mixed muscle tone (hypertonia and hypotonia). Individuals with dyskinetic cerebral palsy have trouble holding themselves in an upright, steady position for sitting or walking, and often show involuntary motions.

See also: Athetosis; Cerebral Palsy; Chorea; Dystonia; Motor Disturbance Classification System

Dyspraxia: A condition that affects the way the brain plans and coordinates physical movement.

Dystocia: When a baby cannot easily pass through the mother’s pelvis during birth, even though the uterus is contracting normally.

See also: Brachial Plexus Injuries (BPI); Erb’s Palsy; Shoulder Dystocia

Dystonia: A neurological disorder that causes muscle contractions in the body. Repetitive movements, abnormal postures and a twisting in the body are often characteristic of dystonia. This disorder can affect one muscle, a muscle group or the entire body.

See also: Cerebral Palsy; Dystonia (Motor Disturbance Classification System of Cerebral Palsy)

Dystonia (Motor Disturbance Classification System of Cerebral Palsy): A subclassification of dyskinetic cerebral palsy based on the nature of dyskinetic movements. Involuntary muscular contractions that cause repetitive, twisting movements, postural abnormalities and painful movements. Movement impairments are often caused by attempts to move in a controlled manner.

See also: Athetosis; Cerebral Palsy; Chorea; Dyskinetic Cerebral Palsy; Dystonia; Motor Disturbance Classification System

E

Eclampsia: Eclampsia is a serious maternal health complication where mothers have severe seizures. This is diagnosed in women with preeclampsia, a condition where the mother is diagnosed with very high blood pressure, high amounts of protein in her urine, and sometimes end-organ dysfunction in the last half of her pregnancy. Eclampsia is a common cause of maternal morbidity and death.

Ectopic Pregnancy: A pregnancy in which the fertilized ovum is implanted outside of the uterus.

EEG (Electroencephalogram): A brain imaging technique used to detect abnormalities of the brain’s electrical activity. EEGs must be performed when a child exhibits seizures or signs of epilepsy.

See also: Brain Imaging Tests; CT Scan; Diagnosis; Evoked Potential Test; MRI; Ultrasound

Elevated Bilirubin: Higher than normal levels of bilirubin in the blood.

See also: Bilirubin; Hyperbilirubinemia; Jaundice; Kernicterus

Emergency C-Section: C-section operations that are not scheduled before delivery begins but are performed when complications arise during labor and/or delivery. Delayed emergency C-sections are instances of medical malpractice that often cause HIE, permanent brain damage, disabilities and birth injuries.

See also: C-Section (Cesarean Section) Delivery

Encephalitis: An inflammation of the brain causing flu-like symptoms, fever, headache, seizures and compromised cognition. An untreated mother with Herpes Simplex Virus (HSV) can transmit the infection to her baby during birth, which results in encephalitis in the baby.

See also: Herpes Simplex Virus (HSV) and Related Injury; Maternal Infections; Neonatal Herpes Encephalitis

Encephalopathy: An umbrella term that includes any type of neurological dysfunction. This may include respiratory and feeding problems, depressed reflexes, low or high muscle tone (appearing stiff or floppy), and/or seizure activity.

See also: Hypoxic Ischemic Encephalopathy (HIE); Neonatal Encephalopathy (NE)

Encephalopathy of Prematurity: A subtype of encephalopathy that specifically affects premature babies. It is marked by periventricular leukomalacia (PVL) and injury to the cerebral cortex, thalamus, basal ganglia and white matter.

Epidural Anesthesia: Epidural anesthesia is the injection of an anesthetic into the lumbar area of the spine in the space between the spinal cord and the dura. Epidurals eliminate sensation from the point of insertion downward. Epidural anesthesia is a type of regional anesthesia that is most commonly used during childbirth.

See also: Anesthesia; General Anesthesia; Regional Anesthesia; Spinal Anesthesia

Epilepsy: A neurological disorder in which the nerve cell activity in the brain is disrupted, causing seizures and unusual behavior. Seizures and epilepsy often result from and are a sign of brain injury and hypoxic ischemic encephalopathy (HIE).

See also: EEG; Seizures

Equilibrium Reactions: Postural reactions that return the displaced body to its original vertical position. Delayed equilibrium reactions are often an early sign of cerebral palsy and developmental delays in babies and young children.

See also: Cerebral Palsy; Developmental Delays; Postural Reactions; Protective Reactions; Righting Reactions

Erb’s Palsy: Arm paralysis of the arm’s main nerves caused by downward traction on the head by the health provider during the delivery process. The C5-C6, or the nerves of the brachial plexus are the most commonly affected.

See also: Brachial Plexus Injury (BPI); Shoulder Dystocia

Erythropoietin: A lipoprotein currently being investigated as an additive measure for increasing the effectiveness of HIE treatment.

Evoked Potential Test: A brain imaging technique that measures a patient’s response to stimuli.

See also: Brain Imaging Tests; CT Scan; Diagnosis; EEG; MRI; Ultrasound

Extracranial Hemorrhage: A traumatic or hypoxic birth injury characterized by sudden, rapid bleeding just outside the skull.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Hypoxia; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

F

Face Presentation: Malpresentation of the fetus in which the baby’s face presents first through the birth canal.

See also: Fetal Presentation; Malpresentation

Fetal Acidosis (Acidemia): Fetal acidosis occurs in situations where the fetus’ blood pH (acidity) is too acidic and outside its normal range. This is different from newborn acidosis, because fetuses cannot compensate with respiratory or renal responses the way a newborn can. This condition is detected using umbilical cord blood acid-base analysis immediately after delivery or by fetal heart monitoring prenatally or during labor and delivery.

Fetal Distress: An obstetrical, labor and delivery complication involving abnormal fetal heart monitoring that occurs when the fetus experiences oxygen deprivation (asphyxia). It is detected by changes in heart rate, decreased fetal movement and abnormal substances in the amniotic fluid. Because fetal distress is an emergency complication, medical professionals must immediately address and manage it to avoid HIE and permanent injury.

See also: Category System for Fetal Heart Monitoring; Fetal Heart Monitoring, Fetal Heart Tracings; Hypoxic Ischemic Encephalopathy (HIE); Improper Fetal Monitoring; Nonstress Test (NST)

Fetal Growth Restriction (FGR): A condition in which compromised and abnormal intrauterine growth results in a smaller than average fetus. In cases of FGR, fetal weight that is below the 10^th percentile for gestational age. Diagnosis is made by prenatal ultrasound. Fetal growth restricted babies are at high risk for intrapartum hypoxic ischemic encephalopathy (HIE) and are delivered before 40 weeks gestation.

See also: Intrauterine Growth Restriction (IUGR)

Fetal Heart Monitoring (Electronic Fetal Heart Monitoring): Electronic fetal heart monitoring records the mother’s contractions and the fetus’ heart beats in response to contractions to monitor for fetal distress. The failure to properly monitor and act on abnormalities on an electronic fetal heart monitor is an act of medical malpractice that can result in hypoxic ischemic encephalopathy (HIE) and permanent injury to the baby.

See also: Category System for Fetal Heart Monitoring; Fetal Distress, Fetal Heart Monitoring, Fetal Heart Tracings; Hypoxic Ischemic Encephalopathy (HIE); Improper Fetal Monitoring, Nonstress Test (NST)

Fetal-Maternal Hemorrhage: When the amount of blood transferred from the baby to the mother during pregnancy is excessive. This can be very dangerous for the baby.

See also: Fetal Distress

Fetal Position: A description of a fetus’ positioning within the uterus based on the location of the fetus within the womb immediately before labor begins.

See also: Breech Presentation (Breech Birth); Face Presentation; Malpresentation (of Fetus); Vertex Presentation

Fetal Presentation: A description of a fetus’ positioning within the uterus based on which part of the fetus’ body will exit (present) first during delivery.

See also: Breech Presentation (Breech Birth); Face Presentation; Fetal Position; Malpresentation (of Fetus); Vertex Presentation

Fetal Stroke: A stroke typically occurring around the time of delivery. Strokes are caused by birth trauma as well as blockages of blood supply to the brain.

See also: Birth Trauma

Fetus: A prenatal human between the embryonic stage and the time of birth.

See also: Gestation

Fine Motor Skills: Functions involved in the movement and coordination of small body systems and muscular sections, such as the fingers. Children with birth injuries, brain damage, cerebral palsy and neurological damage often have fine motor skill impairments and delays.

See also: Cerebral Palsy; Gross Motor Skills; Manual Ability Classification System (Classification of Cerebral Palsy); Motor Skills; Motor Disturbance Classification System

Forceps: A delivery tool that is used to assist vaginal deliveries. Forceps resemble large tongs and are placed on either side of the babies’ heads to guide them down through the birth canal during delivery.

See also: Vacuum Extractors

Fundal Height: The distance measured from the uterus to the pelvic bone. It is common for the number of centimeters in a fundal height measurement to correspond to the week number in pregnancy, although this measurement is not always accurate or reliable, especially in cases of IUGR (FGR) or fetal macrosomia.

See also: Fetal Growth Restriction (FGR); Gestational Age; Intrauterine Growth Restriction (IUGR); Macrosomia

Funisitis: A fetal inflammatory response syndrome (FIRS) within the tissue of the umbilical cord. Funisitis can be benign but can occasionally become harmful.

See also: Umbilical cord

G

Gait Abnormality: Any deviation from the standard gait. Individuals with neurological and musculoskeletal disorders such as cerebral palsy often have gait abnormalities.

See also: Cerebral Palsy; Scissor Gait

General Anesthesia: Anesthesia that affects the whole body and usually induces a loss of consciousness.

See also: Anesthesia; Epidural Anesthesia; Regional Anesthesia; Spinal Anesthesia

Gestation: The process or period of development in which a fetus develops inside a mother.

See also: Fetus; Gestational Age

Gestational Age: A measurement of the current duration of a woman’s pregnancy. Gestational age is measured from the day of an expectant mother’s last menstrual period to the current date as well as by ultrasound

See also: Gestation

Gestational Diabetes: A condition in which diabetes is first diagnosed during pregnancy. It occurs when a pregnant woman’s body fails to create and use as much insulin as it needs.

See also: Macrosomia

Grasping Reflex: A primitive reflex characterized by an infant’s strong grip. Retention of the grasping reflex beyond the first six months of life can be a sign of cerebral palsy and developmental disabilities in a baby.

See also: Primitive Reflexes

Gray Matter (of the Brain): One of two types of tissues making up the central nervous system. Gray matter has a pinkish-gray color in the living brain and contains the cell bodies, dendrites and axon terminals of neutrons, so it is where the synapses are. Gray matter processes information in the brain, sensory perceptions and muscle control. To use an analogy, gray matter is like computer chips in the brain and white matter is like the circuitry connecting those computer chips.

See also: Gray Matter Injury (GMI)

Gray Matter Injury (GMI): Injury to the brain’s gray matter, most typically caused by hypoxic ischemic encephalopathy, which can cause permanent disability, cerebral palsy, muscular impairment and motor function impairment.

See also: Cerebral Palsy; Hypoxic Ischemic Encephalopathy (HIE); Gray Matter

Gross Motor Function Classification System (Classification of Cerebral Palsy): A classification system that organizes cerebral palsy into five groups based on the gross motor function movement abilities of an infant, child or adolescent with cerebral palsy. Children are evaluated based on age and independence and are placed in five levels based on overall gross motor function.

See also: Cerebral Palsy; Gross Motor Skills

Gross Motor Skills: Functions involved in the movement and coordination of large bodily systems and muscular sections, including the arms, legs and trunk. Children with birth injuries, brain damage, cerebral palsy and neurological damage often have gross motor skill impairments and delays.

See also: Cerebral Palsy; Fine Motor Skills; Gross Motor Function Classification System (Classification of Cerebral Palsy); Motor Skills; Motor Disturbance Classification System

Group B Strep (GBS): A common bacterium found in the female intestines and genital tract. Though is it often harmless to the mother, GBS can cause injury, infection and death in a fetus or newborn. GBS is treatable with antibiotics.

See also: Maternal Infections

H

Hematoma: An abnormal collection of blood outside of a blood vessel.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Hemiparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which one side of the body is weak or partially paralyzed from neurological damage. For instance, a person with hemiparesis would have a weakened or paralyzed right arm and leg, or a weakened or paralyzed left arm and leg.

See also: Cerebral Palsy; Limb Involvement Classification System; Hemiplegia (Hemiplegic Cerebral Palsy); -paresis

Hemiplegia (Hemiplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which one side of the body is affected more than the other side.

See also: Cerebral Palsy; Limb Involvement Classification System

Herpes Simplex Virus (HSV) and Related Injury: A sexually transmitted infection that causes sores to form around the mouth (HSV-1) or the genitals (HSV-2). If left untreated, the mother can pass it onto her child during delivery. When transmitted to a baby, the infection changes and can cause encephalitis (neonatal herpes encephalitis) and severe brain damage.

See also: Encephalitis; Herpes Simplex Virus (HSV) and Related Injury; Maternal Infections; Neonatal Herpes Encephalitis

HIE: The abbreviated form of hypoxic ischemic encephalopathy. See Hypoxic Ischemic Encephalopathy entry.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

High-Risk Pregnancy: A pregnancy involving any underlying potential complications that could harm the mother and/or baby. Some factors characterizing certain pregnancies as high-risk include maternal medical conditions (such as preeclampsia, maternal hypertension, obesity, gestational diabetes, infection and more), preexisting medical conditions (such as STIs, small pelvic size, history of IUGR, placental abruption and more), maternal age under 17 or over 35, multiple gestations, fetal conditions, premature labor, obstetrical complications and more. High-risk pregnancies increase a baby’s risk for experiencing birth injuries and birth trauma. Medical professionals must perform all duties within care standards to properly manage high-risk pregnancies and prevent birth injury.

See also: Birth Injury; Birth Trauma; Gestational Diabetes; Intrauterine Growth Restriction (IUGR); Placental Abruption; Preeclampsia

Hippotherapy: A form of equine-assisted therapy. In hippotherapy sessions, the multidimensional swinging rhythm of the horse’s walk is transferred to the child’s pelvis in a manner that duplicates the normal human gait. The movement of the horse is the treatment tool that helps achieve the goals of strength, balance and normalization of muscle tone. Some people with cerebral palsy and gait abnormalities participate in hippotherapy.

See also: Cerebral Palsy; Muscle Tone; Recreational Therapy; Therapeutic Horseback Riding

Hydatidiform Mole (Molar Pregnancy): The result of an abnormal conception that leads to minimal fetal development but excessive placental development. Most hydatidiform moles are benign, although they can very occasionally lead to carcinoma.

Hydrocephalus (Fluid in the Brain): A condition in which there is an excessive buildup of fluid in the brain. The condition is caused by cerebrospinal fluid (CSF) entering the brain, creating abnormally wide spaces in the brain called ventricles. The widening puts harmful pressure on the tissues of the brain.

See also: Microcephaly

Hyperbaric Oxygen Therapy (HBOT): A therapeutic method in which a high partial pressure of oxygen enhances and speeds up the body’s healing process.

See also: Alternative Therapy; Complementary Therapy

Hyperbilirubinemia: An abnormally high level of bilirubin in the blood demonstrated by jaundice, lethargy, associated with liver and hemolytic disease.

See also: Bilirubin; Elevated Bilirubin; Jaundice; Kernicterus

Hyperstimulation (Uterine Hyperstimulation; Tachysystole): Excessive frequency and strength of uterine contractions, characterized by single contractions that last longer than two minutes or five or more contractions that occur within ten minutes. Hyperstimulation limits blood flow through the umbilical cord during contractions and can cause serious fetal oxygen deprivation and hypoxic ischemic encephalopathy (HIE).

See also: Hypertonicity; Hypoxic Ischemic Encephalopathy (HIE); Strong Contractions; Tachysystole

Hypertonia: Abnormally high muscle tone.

See also: Cerebral Palsy; Hypotonia; Muscle Tone; Muscle Tone Classification System

Hypertonicity: A dangerous labor and delivery complication that occurs when there is no rest or not enough rest in between uterine contractions. Excessive uterine contractions, a condition known as hyperstimulation or tachysystole, leads to hypertonicity of the uterus. Hypertonicity interferes with the passage of oxygen to the baby, often causing birth asphyxia, hypoxic ischemic encephalopathy (HIE) and birth injury.

See also: Cytotec; Hyperstimulation; Pitocin; Hypertonicity; Strong Contractions; Tachysystole

Hypocalcemia: Low serum calcium in the blood. This calcium is critical for neural function, membrane stability, cell function, blood coagulation and bone structure.

See also: Seizures

Hypocarbia (Hypocapnia): Low carbon dioxide in the blood due to deep or heavy breathing or overventilation. Hypocarbia often occurs when a baby suffers overventilation on breathing equipment (a situation in which the baby is given breaths too quickly or too deeply). In the neonatal period, overventilation and hypocarbia cause decreased cerebral blood flow which can cause periventricular leukomalacia (PVL), cerebral palsy and other injuries.

See also: Neonatal Breathing Problems; Overventilation; Surfactant; Periventricular Leukomalacia (PVL)

Hypoglycemia: Low blood sugar. People affected may experience nausea, blackout, blurred vision, stupor, tremor, anxiety or a headache.

See also: Neonatal Hypoglycemia

Hypotension: Abnormally low blood pressure. Maternal hypotension is a risk factor for IUGR and can cause dangerous pregnancy complications such as birth injuries and hypoxic ischemic encephalopathy (HIE).

See also: Birth Injury; Hypoxic Ischemic Encephalopathy (HIE); Preeclampsia

Hypothermia Treatment (Brain Cooling): The only known effective treatment for hypoxic ischemic encephalopathy (HIE). During hypothermia treatment, the body temperature of a newborn baby with HIE is lowered with a cooling blanket or cap to 33.5 degrees Celsius for 72 hours. Cooling the body and brain of a baby with HIE slows the metabolic rate, allowing cells to recover and preventing the spread, severity and permanence of brain damage.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy (NE)

Hypotonia: Low muscle tone. Hypotonia is characterized by limpness or floppiness and is often secondary to birth injury and birth trauma.

See also: Birth Injury; Birth Trauma; Cerebral Palsy; Hypertonia; Hypotonic Cerebral Palsy; Muscle Tone; Muscle Tone Classification System

Hypotonic Cerebral Palsy: A form of cerebral palsy characterized by low muscle tone. Hypotonic cerebral palsy is caused by brain damage or, occasionally, brain malformations.

See also: Cerebral Palsy; Hypotonia; Muscle Tone

Hypoxia: A shortage of oxygen in the blood.

See also: Cerebral Hypoxia; Hypoxic-Anoxic Injury; Hypoxic Ischemic Encephalopathy (HIE)

Hypoxic-Anoxic Injury (HAI): Brain injuries caused by hypoxic or anoxic oxygen deprivation. Hypoxic-anoxic injuries can occur before or at the time of birth and cause permanent disabilities and birth injuries.

See also: Anoxia; Anoxic Brain Injury; Cerebral Anoxia; Cerebral Hypoxia; Hypoxia; Hypoxic-Anoxic Injury; Hypoxic Ischemic Encephalopathy (HIE)

Hypoxic Ischemic Encephalopathy (HIE): A neonatal brain injury caused by oxygen deprivation and limited blood flow to the baby’s brain at or near the time of birth. Cell death and subsequent brain damage occur when the brain does not receive adequate oxygenation. HIE is the most common type of neonatal encephalopathy (NE). HIE can cause disabilities and injuries including cerebral palsy, seizures, intellectual and developmental disabilities (I/DD) and learning disabilities.

See also: Acute Profound Asphyxia; Asphyxia; Birth Asphyxia; Encephalopathy; Hypothermia Treatment; Hypoxia; Intrapartum Asphyxia; Ischemia; Mixed Injury Pattern Asphyxia; Neonatal Encephalopathy (NE); Partial Prolonged Asphyxia

I

Implantation Bleeding: Spotting that occurs when a fertilized egg implants into the uterine lining about 1-2 weeks after conception.

Improper Fetal Monitoring: The failure of medical professionals to correctly monitor or interpret electronic fetal heart monitoring.

See also: Category System for Fetal Heart Monitoring; Fetal Distress, Fetal Heart Monitoring, Fetal Heart Tracings; Hypoxic Ischemic Encephalopathy (HIE); Nonstress Test (NST)

Incompetent Cervix (Insufficient Cervix): An obstetrical complication that occurs when weak cervical tissue causes or contributes to miscarriage or premature birth.

See also: Betamethasone; Cervical Cerclage; Magnesium Sulfate; Premature Birth; Premature Rupture of Membranes (PROM); Progesterone; Tocolytics

Intellectual and Developmental Disabilities (I/DD): A disability characterized by profound limitations in cognitive function and adaptive behavior. I/DD is diagnosed before the age of 18 and impairs learning, reasoning, problem solving, social skills and more.

See also: Developmental Delays; Developmental Milestones

Intervillous Space: Space in the placenta where maternal blood travels.

Intracranial Hemorrhages (Brain Bleeds): A traumatic or hypoxic birth injury characterized by bleeding within the skull or brain.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Hypoxia; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Intrapartum Asphyxia (Intrauterine Asphyxia): A lack of oxygen flow to the brain before or during labor and delivery or childbirth. Intrapartum asphyxia is very dangerous and can lead to neonatal encephalopathy (NE) and hypoxic ischemic encephalopathy (HIE). Intrapartum asphyxia is another term for birth asphyxia.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Neonatal Encephalopathy (NE)

Intrauterine Growth Restriction (IUGR): A condition in which compromised and abnormal intrauterine growth results in a smaller than average fetus. In cases of IUGR, fetal weight that is below the 10^th percentile for gestational age. IUGR babies are at high risk for intrapartum hypoxic ischemic encephalopathy (HIE) and are delivered before 40 weeks gestation.

See also: Fetal Growth Restriction (FGR)

Intraventricular Hemorrhage (IVH – Brain Bleed): A type of intracranial hemorrhage in which blood enters the ventricular system, where spinal fluid is produced. This is the most serious type of brain bleed and is most commonly seen in premature infants and infants with low birth weight.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Intubation: A procedure in which a plastic tube is placed in the trachea, or windpipe, in order to keep the airway open.

Ischemia: A shortage of blood flow to the brain.

See also: Hypoxic Ischemic Encephalopathy (HIE)

J

Jaundice: An excess of bilirubin in the blood, which causes yellow coloration of the eyes and skin. Medical professionals must diagnose and treat jaundice in order to avoid kernicterus and permanent brain injury.

See also: Bilirubin; Elevated Bilirubin; Hyperbilirubinemia; Kernicterus

The July Effect: A temporary increase in the occurrences of medical errors in the summer months when medical students graduate from school and begin working on patients. Many experienced caregivers are also on vacation during this time period.

See also: Medical Malpractice; Negligence (Medical Negligence); Resident Physician Fatigue

K

Kernicterus: A severe condition that occurs when bilirubin levels are so high that they move from the blood and into brain tissues. Kernicterus is easily treatable. It can cause brain damage and permanent injury if not diagnosed and treated in a timely manner.

See also: Bilirubin; Elevated Bilirubin; Hyperbilirubinemia; Jaundice

L

Labor and Delivery Nurse: A registered nurse that provides medical care for women during the process of labor and delivery.

Lactobacilli: A part of the lactic acid bacteria group found in the vagina.

See also: Group B Strep (GBS)

Leukopenia: A low count of white blood cells.

Limb Involvement Classification System (Classification of Cerebral Palsy): A classification system that organizes cerebral palsy into types based on the location of limb impairment, as well as the number of limbs affected by the brain injury.

See also: Cerebral Palsy; Diplegia; Double Hemiplegia; Hemiplegia; Monoplegia; Paraplegia; Pentaplegia; Quadriplegia; Triplegia

Linear Skull Fracture: A thin break in the cranial bone. Linear skull fractures typically occur on the parietal bone, but can occur in the frontal or occipital bones. They occasionally occur with a cephalohematoma (cephalhematoma) and are often caused by the misuse of delivery instruments such as vacuum extractors or forceps.

See also: Birth Trauma; Cephalohematoma (Cephalhematoma); Depressed Skull Fracture; Forceps; Intracranial Hemorrhages (Brain Bleeds); Occipital Osteodiastasis; Skull Fractures (Cranial Fractures); Vacuum Extractors

M

Macrosomia (Fetal Macrosomia): A larger than average newborn baby. Macrosomia is typically diagnosed in babies that weigh more than 8 pounds and 13 ounces.

See also: Gestational Diabetes

Magnesium Sulfate Treatment: When a mother is expected to go into preterm labor within 24 hours, medical professionals will administer magnesium sulfate to protect the fetus from neurological damage. Magnesium sulfate has neuroprotective effects and is typically given to women with premature rupture of membranes (PROM) or another indication of premature delivery.

See also: Cerebral Palsy; Premature Birth

Malpresentation (of a Fetus): Any type of fetal presentation besides the vertex presentation. Types of fetal malpresentation include face presentation, shoulder presentation, brow presentation and breech presentation.

See also: Breech Presentation (Breech Birth); Face Presentation; Fetal Position; Fetal Presentation; Vertex Presentation

Manual Ability Classification System (Classification of Cerebral Palsy): A classification system that organizes cerebral palsy into five groups categories based on one’s ability to perform manual activities.

See also: Cerebral Palsy; Fine Motor Skills

Massage Therapy: Any therapeutic method in which soft bodily tissues are manually manipulated in order to achieve therapeutic goals. Individuals with birth injuries such as cerebral palsy may benefit from massage therapy.

See also: Alternative Therapy; Complementary Therapy; Massage Therapy; Therapy

Maternal Infections: Infections in a pregnant woman. Without proper treatment, maternal infections can cause infection and permanent injury in the baby.

See also: Bacterial Vaginosis (BV); Chorioamnionitis; Group B Strep (GBS); Herpes Simplex Virus (HSV); Urinary Tract Infection (UTI); Villitis

Meconium Aspiration Syndrome (MAS): A serious medical condition in which the fetus breathes a mixture of meconium (the baby’s stool) and amniotic fluid into its lungs around the time of delivery.

Medical Malpractice (Medical Negligence): Medical malpractice occurs when a medical professional deviates from the standard of care, and that deviation causes injury or harm to the patient.

See also: Birth Injury; Birth Trauma; The July Effect; Negligence (Medical Negligence); Resident Physician Fatigue

Meningitis: An inflammation caused by an infection of the membranes that cover the brain and spinal cord. Bacterial meningitis is the most common type of meningitis followed by viral and fungal meningitis. Untreated maternal colonizations and infections and premature birth are common causes of meningitis in newborns.

See also: Maternal Infections; Premature Birth; Sepsis (Neonatal Sepsis)

Mesenchymal Stem Cells: A type of stem cell that can differentiate into multiple other kinds of cells. These are currently being tested as a potential therapy for hypoxic-ischemic encephalopathy.

See also: Stem cells

Metronidazole: A prescribed medication that treats bacterial infections in the stomach, vagina, skin, joints and respiratory tract.

Microcephaly: Abnormally small head circumference (less than the 10th percentile) most typically caused by brain damage from birth trauma or birth injury.

See also: Birth Injury; Birth Trauma; Hydrocephalus

Midwife: A person trained to assist women during labor and delivery. Many midwives also provide birth education and prenatal care, and, depending on the law, they may work independently, as part of a team or with a hospital.

Mild Cerebral Palsy: A classification of cerebral palsy based on the severity of impairments. Those with mild cerebral palsy may sometimes be partially independent depending on their cognitive abilities.See also: Cerebral Palsy; Severity (Classification of Cerebral Palsy)

Mild Hypoxic Ischemic Encephalopathy (HIE) (Sarnat Stage I): The least severe classification of hypoxic ischemic encephalopathy (HIE) as determined on the Sarnat Grading Scale. Characteristics of mild HIE include hyper-alert consciousness, normal muscle tone, normal activity, overactive stretch reflexes, mild distal flexion, weak sucking reflex, strong startle reflex, slight tonic neck reflex, no seizure activity, dilated pupils and tachycardia.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy; Sarnat Staging

Mismanaged Fetal Growth Restriction (FGR): Failure to properly manage any condition that can cause fetal growth restriction, as well as the failure to diagnose and plan a timely delivery before 40 weeks of gestation. Mismanaged fetal growth restriction can cause severe injury in the baby, including hypoxic ischemic encephalopathy (HIE), permanent brain damage, cerebral palsy, seizures, intellectual disabilities and developmental delays.

See also: Fetal Growth Restriction; Intrauterine Growth Restriction (IUGR)

Mixed Cerebral Palsy: A type of cerebral palsy based on the Motor Disturbance Classification System. Mixed cerebral palsy is characterized by both hypertonia (abnormally high muscle tone) and hypotonia (abnormally low muscle tone). When an individual case of cerebral palsy includes impairments and features of both spastic and non-spastic cerebral palsy, it is considered mixed cerebral palsy.

See also: Cerebral Palsy; Motor Disturbance Classification System

Mixed Injury Pattern Asphyxia: A term describing the extent of oxygen deprivation in cases of hypoxic ischemic encephalopathy (HIE). When a neonate experiences oxygen deprivation patterns characteristic of both acute profound asphyxia and partial prolonged asphyxia, the type of HIE is classified as mixed injury pattern asphyxia. Mixed injury pattern asphyxia can occur before, during or after delivery.

See also: Acute Profound Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Partial Prolonged Asphyxia

Moderate Cerebral Palsy: A classification of cerebral palsy based on the severity of impairments. Those with moderate cerebral palsy require some assistance from assistive technology, adaptive equipment and other people to perform daily tasks.

See also: Cerebral Palsy; Severity (Classification of Cerebral Palsy)

Moderate Hypoxic Ischemic Encephalopathy (HIE) (Sarnat Stage II): The middlemost severe classification of hypoxic ischemic encephalopathy (HIE) as determined on the Sarnat Grading Scale. Characteristics of moderate HIE include lethargy, mild hypotonia (decreased muscle tone), decreased activity, strong distal flexion, overactive stretch reflexes, weak or absent suck reflex, weak startle reflex, strong tonic neck reflex, miosis (constriction of the pupil), bradycardia and seizure activity.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy; Sarnat Staging

Monoparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which one limb is weak or partially paralyzed from neurological damage.

See also: Cerebral Palsy; Limb Involvement Classification System; Monoplegia (Monoplegic Cerebral Palsy); -paresis

Monoplegia (Monoplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which one limb is affected.

See also: Cerebral Palsy; Limb Involvement Classification System; Monoparesis

Motor Disorders: When damage to the motor or nervous systems causes abnormal and uncontrollable movements in the body.

See also: Cerebral Palsy

Motor Disturbance Classification System (Classification of Cerebral Palsy): A classification system that organizes cerebral palsy into four main types based on the location of the brain injury and the brain injury’s corresponding movement impairments. The four types include spastic cerebral palsy, ataxic cerebral palsy, dyskinetic cerebral palsy and mixed cerebral palsy.

See also: Ataxic Cerebral Palsy; Cerebral Palsy; Dyskinetic Cerebral Palsy; Mixed Cerebral Palsy; Spastic Cerebral Palsy

Motor Skills: Any function that involves using the muscles to complete an action. Motor skills are orchestrated by the nervous system, brain and muscles. Motor skills are divided into two primary categories to describe the scale of movement, which include gross motor skills and fine motor skills. Children with birth injuries, brain damage, cerebral palsy and neurological damage often have motor skill impairments and delays.

See also: Cerebral Palsy; Fine Motor Skills; Gross Motor Function Classification System; Gross Motor Skills; Manual Ability Classification System; Motor Disturbance Classification System; Oral Motor Skills

MRI (Magnetic Resonance Imaging): A brain imaging technique that uses a magnetic field and pulses of radio wave energy to make images of the brain. MRIs of a baby’s brain help diagnose brain injuries such as hypoxic ischemic encephalopathy (HIE), intracranial hemorrhages, hydrocephalus, white matter brain damage, cerebral palsy and other injuries and disorders.

See also: Brain Imaging Tests (Neuroimaging); CT Scan; Diagnosis; EEG; Evoked Potential Test; PET Scan; Ultrasound

Multiple Gestation: Another term for multiple births, referring to twins or a higher number of fetuses. Multiple gestations are considered to be high-risk as they are often complicated with prematurity, low birth weight, preeclampsia, postpartum hemorrhage, intrauterine growth restriction, hypoxic ischemic encephalopathy (HIE), and high neonatal and infant mortality.

See also: Fetus; Gestation; High-Risk Pregnancy

Muscle Tone: In medicine, muscle tone is the internal state of muscle-fiber tension of a particular muscle.

See also: Hypertonia; Hypotonia

Muscle Tone (Classification of Cerebral Palsy): A classification system that organizes cerebral palsy into two categories based on muscle tone, which includes hypertonia and hypotonia.

See also: Cerebral Palsy; Hypertonia; Hypotonia

Myoclonic Seizures: A classification of neonatal seizures. Epileptic seizures have myoclonus, or a jerking motion as a symptom. People who have these type of seizures are usually awake and able to think clearly. Myoclonic seizures are associated with premature babies.

See also: Epilepsy; Seizures

Myoclonus: A type of spasm, or jerking motion of the muscles or groups of muscles.

See also: Myoclonic Seizures

N

Necrosis: An injury or lack of blood flow to the cells that causes tissues to die prematurely. This is often caused by radiation and chemicals. In cases of periventricular leukomalacia (PVL), the white matter near the ventricles softens and undergoes necrosis.

See also: Periventricular Leukomalacia (PVL)

Negligence (Medical Negligence or Medical Malpractice): Medical negligence occurs when a medical professional deviates from the standards of care, and that deviation causes injury or harm to the patient.

See also: The July Effect, Medical Malpractice, Resident Physician Fatigue

Neonatal Asphyxia: See Birth Asphyxia

See also: Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

Neonatal Breathing Problems: Also called neonatal respiratory distress syndrome. This can occur in premature infants who have undeveloped lungs. An absence or lack of surfactant, which keeps the air sacs from deflating, is often the cause.

See also: Hypocarbia (Hypocapnia); Overventilation; Surfactant

Neonatal Breathing Problems in Term Babies: Babies can have apneas and bradycardias, which are breathing problems and slow heart rate, usually secondary to HIE, but also may be a sign of a baby needing careful monitoring, resuscitation and intubation or ventilation.

See also: Apnea; Bradycardia; Hypocarbia (Hypocapnia); Neonatal Breathing Problems; Overventilation

Neonatal Encephalopathy (NE): A broad term used to describe disturbed neurological function in a newborn baby. Some signs and symptoms of disturbed neurological function in the newborn infant may include respiratory distress, feeding problems, depressed reflexes, low or high muscle tone (stiff or floppy appearance) and/or seizure activity. Hypoxic ischemic encephalopathy (HIE) is the most common type of neonatal encephalopathy.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia

Neonatal Herpes Encephalitis: A viral infection in the brain that mothers with an HSV outbreak transmit to their babies during delivery. HSV can cause neonatal encephalitis, infant brain damage, cerebral palsy and other injuries.

See also: Encephalitis; Herpes Simplex Virus (HSV) and Related Injury; Maternal Infections

Neonatal Hypoglycemia (Low Blood Sugar): When a newborn’s plasma glucose level is lower than 30 mgs.

See also: Hypoglycemia

Neonatal Intensive Care Unit (NICU): A special care unit of the hospital dedicated to treating and caring for newborn babies in need of intensive medical care.

See also: Neonatal Period; Neonate; Birth Injury; Birth Trauma

Neonatal Period: The period of time spanning from birth to the age of one month. During the neonatal period, babies are very fragile and must be closely monitored and carefully treated. Mistakes in a baby’s medical care can have major effects on the baby’s health and cause permanent brain damage, injury and disability.

See also: Neonate; NICU

Neonatal Brain Damage: Neonatal brain damage is brain damage that occurs during the labor and delivery process, or after a child is born. This can happen due to a number of factors, including infections, trauma to the head (neonatal brain injury), hypoglycemia, or medical errors.

Neonatal Brain Injury: Neonatal brain injury is a subset of brain injury that occurs during the labor and delivery process or after a child is born.

See also: Brain damage, brain injury, neonatal brain damage

Neonate: An infant younger than four weeks old.

See also: Neonatal Period

Neuropsychologist: A physiologist who specializes in understanding the physical brain and how it processes behavior.

NICU: Neonatal Intensive Care Unit (Also called Intensive Care Nursery, or ICN).

See also: Neonatal Period; Neonate; Birth Injury; Birth Trauma

Non-Spastic Cerebral Palsy: A type of cerebral palsy characterized by the absence of spasticity. Types of non-spastic cerebral palsy include dyskinetic cerebral palsy, ataxic cerebral palsy and athetoid cerebral palsy.

See also: Ataxic Cerebral Palsy; Athetoid Cerebral Palsy; Cerebral Palsy; Dyskinetic Cerebral Palsy; Muscle Tone; Spastic Cerebral Palsy; Spasticity

Nonreassuring Fetal Heart Tones: Indications that a there may be a problem or abnormality with the baby. Nonreassuring fetal heart tones are used when heart tones suggest that the baby may not be getting enough oxygen.

See also: Category System for Fetal Heart Monitoring; Fetal Distress, Fetal Heart Monitoring, Fetal Heart Tracings; Hypoxic Ischemic Encephalopathy (HIE); Improper Fetal Monitoring; Nonstress Test (NST), Category System

Nuchal Cord: A pregnancy, labor and delivery complication in which the umbilical cord wraps around the fetus’ neck. Nuchal cords can disrupt the normal flow of blood, gases, and nutrients from the mother to the fetus and can cause severe injuries including hypoxic-ischemic encephalopathy (HIE) and cerebral palsy.

See also: Cerebral Palsy; Hypoxic-Ischemic Encephalopathy (HIE); Umbilical Cord; Umbilical Cord Compression; True Knot

Nutrition and Diet Therapy: A therapeutic approach targeting individualized diets and nutrition plans.

See also: Complementary Therapy

O

Obstetrics: A field of study that focuses on pregnancy, childbirth and postpartum health care. Obstetrics combines with gynecology (OB/GYN).

Occipital Osteodiastasis: A traumatic type of skull fracture that can occur during delivery, most typically by use of forceps. The squamous and lateral parts of the occipital bone separate and lacerate the occipital sinus, causing blood to pool in the area of the brain containing the brainstem and cerebellum (the posterior fossa).

See also: Birth Trauma; Depressed Skull Fracture; Intracranial Hemorrhages (Brain Bleeds); Linear Skull Fracture; Skull Fractures (Cranial Fractures)

Occult Umbilical Cord Prolapse: When the cord descends alongside but not past the presenting part of the baby. It can occur with ruptured or intact membranes.

See also: Umbilical cord; Umbilical Cord Prolapse; Overt Umbilical Cord Prolapse

Occupational Therapist: A professional who assesses and determines the treatment and goals of people living with physical or mental disabilities. Occupational therapists determine goals to help the disabled build or maintain more independent lives.

See also: Occupational Therapy; Therapy

Occupational Therapy: A therapeutic method that aims to improve, enhance and restore a disabled person’s ability to complete tasks of daily living.

See also: Cerebral Palsy; Occupational Therapist; Therapy

Oligohydramnios: Low levels of amniotic fluid in the womb. Low amniotic fluid levels increase the risk of umbilical cord compression and hypoxic ischemic encephalopathy (HIE).

See also: Amniotic Fluid; Hypoxic Ischemic Encephalopathy (HIE); Polyhydramnios

Ophthalmologist: A doctor who specializes in the medical and surgical care of the eyes.

See also: Visual Impairment

Oral Motor Skills: Functions involved in the movement and coordination of the mouth, tongue, lips, jaw and palates. Children with birth injuries, brain damage, cerebral palsy and neurological damage may have oral motor skill impairments and delays.

See also: Cerebral Palsy; Communication Function Classification System; Motor Skills; Motor Disturbance Classification System

Orthopedic Surgeon: A doctor who specializes in the surgical care of the musculoskeletal system.

Overt Umbilical Cord Prolapse: When the cord comes out of the cervix or vagina before the presenting part of the baby and is either visible or able to be felt by the medical practitioner.

See also: Umbilical cord; Umbilical Cord Prolapse; Occult Umbilical Cord Prolapse

Overventilation (Hyperventilation): Overventilation or hyperventilation occurs when a newborn on breathing equipment is given breaths that are so large and/or fast that they cause the baby to exhale too much carbon dioxide (a condition called hypocarbia or hypocapnia). When air is breathed too deep and too fast, rapid breathing can lead to low carbon dioxide concentration in the blood. Hypocarbia causes decreased cerebral perfusion, which in turn causes periventricular leukomalacia (PVL).

See also: Hypocarbia (Hypocapnia); Neonatal Breathing Problems; Periventricular Leukomalacia (PVL)

Oxygen Deprivation: The brain requires the exchange of gases (including oxygen) in order to function. When placental or pulmonary gas exchange is interrupted or reduced, oxygen deprivation occurs. When there is not enough oxygen, widespread cell death occurs throughout the body (including the brain), causing a wide variety of different dysfunctions on both a cellular, organ-wide, and systemic level.

Oxytocin: See Pitocin

See also: Cytotec; Hyperstimulation; Pitocin; Hypertonicity; Strong Contractions; Tachysystole

P

Paraparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which the lower body is weakened or paralyzed due to neurological damage.

See also: Cerebral Palsy; Limb Involvement Classification System; Pentaplegia (Pentaplegic Cerebral Palsy); -paresis

Paraplegia (Paraplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which the lower body is affected.

See also: Cerebral Palsy; Limb Involvement Classification System

-paresis: Weakness or partial paralysis caused by neurological damage (suffix). E.g., paraparesis.

See also: Cerebral Palsy; Limb Involvement Classification System

Partial Prolonged Asphyxia: A term describing the extent of oxygen deprivation in cases of hypoxic ischemic encephalopathy (HIE). Partial prolonged asphyxia occurs when a baby suffers oxygen deprivation for 30 minutes or longer. Known causes of partial prolonged asphyxia include oligohydramnios, preeclampsia and hypertension, hypotension, strong contractions and uterine hyperstimulation, placental insufficiency, umbilical cord prolapse, umbilical cord compression, short umbilical cord length and nuchal cords.

See also: Acute Profound Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Mixed Injury Pattern Asphyxia

Pediatric Neurologist: A doctor who specializes in treating the nervous system, including the spinal cord and brain of babies and children.

Pediatric Rehabilitation Medicine Specialist: A medical professional specializing in the treatment of pediatric disabilities.

Pelvic Organ Prolapse: When the pelvic organs protrude out of the vaginal canal.

PEG Tube (Percutaneous Endoscopic Gastrostomy Tube): Also known as a feeding gastrostomy tube, a PEG tube is a tube placed in the stomach through the abdominal wall. PEG tubes allow people with feeding difficulties to receive nutrition directly into the stomach. Many children with cerebral palsy use PEG tubes.

Pentaparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which both arms, both legs, the head and the neck are weakened or paralyzed due to neurological damage.

See also: Cerebral Palsy; Limb Involvement Classification System; Pentaplegia (Pentaplegic Cerebral Palsy); -paresis

Pentaplegia (Pentaplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which both legs, both arms, the head and the neck are affected.

See also: Cerebral Palsy; Limb Involvement Classification System

Perinatal Asphyxia: See Birth Asphyxia

See also: Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

Perinatal Period: The period immediately before and after birth.

Periventricular Leukomalacia (PVL): A serious type of neonatal brain injury that occurs when a lack of oxygen and blood flow to the brain softens and kills the brain’s white matter near the lateral ventricles, which provide pathways for cerebrospinal fluid. Fluid-filled cysts are often left in place of the dead white matter. PVL is often caused by HIE or birth trauma and can lead to cerebral palsy, epilepsy, intellectual and developmental delays (I/DD) and visual impairment.

See also: Birth Trauma; Cerebral Palsy; Epilepsy; Hypoxic Ischemic Encephalopathy (HIE); Intellectual and Developmental Disabilities (I/DD); Visual Impairment; White Matter

PET Scan (Positron Emission Tomography Scan): An imaging test that uses a radioactive material (tracer) to trace diseases in the body and show how bodily tissues and organs are functioning.

See also: Brain Imaging Tests (Neuroimaging); Diagnosis

Phototherapy: Treatment for jaundice (hyperbilirubinemia) whereby a baby is placed under special lights designed to decrease bilirubin levels.

See also: Elevated Bilirubin; Hyperbilirubinemia; Jaundice; Kernicterus

Physical Therapy: A therapeutic method aimed at improving and/or restoring physical limitations. Children with cerebral palsy often take part in physical therapy regimens to improve motor and developmental abilities.

See also: Cerebral Palsy; Therapy

Pitocin (Oxytocin): A drug used to induce or augment labor contractions and make them stronger and more frequent. Pitocin use can be very risky and can cause hypertonicity, hyperstimulation, strong contractions, tachysystole, fetal oxygen deprivation, hypoxic ischemic encephalopathy (HIE) and permanent injury.

See also: Cytotec; Hyperstimulation; Hypertonicity; Hypoxic Ischemic Encephalopathy (HIE); Oxytocin; Strong Contractions; Tachysystole

Placenta: A circular organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination and gas exchange via the mother’s blood supply. The placenta nourishes the baby through the umbilical cord.

See also: Placenta; Placenta Accreta; Placenta Increta; Placenta Percenta; Placenta Previa; Placental Abruption; Placental Insufficiency; Umbilical Cord

Placenta Accreta: A pregnancy complication in which the placenta embeds too deeply into the uterine wall. In cases of placenta accreta, the placenta does not penetrate the muscle of the uterus. Placenta accreta can cause maternal hemorrhaging with subsequent fetal hypoxia and hypoxic-ischemic encephalopathy (HIE).

See also: Placenta; Placenta Increta; Placenta Percenta

Placenta Increta: A severe form of placenta accreta in which the placenta embeds so deeply into the uterine wall that it penetrates the uterine muscle. Placenta increta can cause maternal hemorrhaging and hypoxic-ischemic encephalopathy (birth asphyxia; HIE).

See also: Placenta; Placenta Accreta; Placenta Percenta

Placenta Percenta: Placenta percenta is the most severe form of placenta accreta. It occurs when the placenta embeds so deeply into the uterine wall that it attaches onto or penetrates one of the pregnant woman’s other organs. Placenta percenta can cause severe maternal hemorrhaging and hypoxic-ischemic encephalopathy (birth asphyxia; HIE).

See also: Placenta; Placenta Accreta; Placenta Increta

Placenta Previa: When the placenta grows to close so the opening of the uterus that is partially or completely blocks the opening of the cervix.

See also: Placenta; Placental Abruption; Placental Insufficiency

Placental Abruption: An obstetrical emergency in which the placenta partially or fully separates from the uterus. Placental abruption interferes with the flow of oxygen, blood and nutrients from the mother to the fetus.

See also: Placenta; Placental Insufficiency; Placenta Previa

Placental Insufficiency: A lack of adequate blood flow, oxygen flow and nutrient passage from the placenta to the fetus.

See also: Placenta; Placental Abruption; Placenta Previa

-plegia: Paralysis (suffix). E.g., paraplegia, paraplegic cerebral palsy.

See also: Cerebral Palsy; Limb Involvement Classification System

Polyhydramnios: Excessive amounts of amniotic fluid.

See also: Amniotic Fluid; Oligohydramnios

Postdate Pregnancy: A pregnancy lasting longer than 42 weeks of gestation. Post-term pregnancies increase the risk of birth trauma, intracranial hemorrhages, hypoxic ischemic encephalopathy (HIE), infant brain damage, cerebral palsy, seizures and other injuries and complications.

See also: Post-Term Pregnancy

Posterior Presentation (Occiput Posterior Presentation): The posterior position, also known as the occiput posterior (OP) position or the “sunny side up” position, occurs when the baby is in a head-first, forward facing position. Babies in the posterior position will be face up when they’re delivered. Posterior position can cause labor dystocia and resultant birth injuries.

Post-Term Pregnancy (Postterm Pregnancy; Postdate Pregnancy): A pregnancy lasting longer than 42 weeks of gestation. Post-term pregnancies increase the risk of birth trauma, intracranial hemorrhages, hypoxic ischemic encephalopathy (HIE), infant brain damage, cerebral palsy, seizures and other injuries and complications.

See also: Postmaturity Syndrome

Postmaturity Syndrome: Occurring in roughly 20% of postdate pregnancies, this syndrome develops due to uteroplacental insufficiency, which causes chronic stress and hypoxia (oxygen deprivation) in the baby. Babies with postmaturity syndrome have unique appearances including overgrown fingernails and hair, long bodies with little fat, and wrinkled or dry, parchment-like skin.

See also: Post-Term Pregnancy

Postpartum Depression: A type of clinical depression that can affect a mother and father after the birth of a child. In about 1 or 2 per 1,000, postpartum depression can lead to postpartum psychosis.

Postpartum Hemorrhage (PPH): When a woman bleeds heavily after the delivery of her baby. This can be very dangerous for the mother.

See also: Uterine Atony

Postural Reactions: Mature reflexes that control coordination of movement, balance, sensory development and motor development. Delayed development of postural reactions is often an early sign of developmental disabilities and cerebral palsy.

See also: Cerebral Palsy; Developmental Delays; Equilibrium Reactions; Primitive Reflexes; Protective Reactions; Righting Reactions

Preeclampsia: Pregnancy-induced high blood pressure. In addition to maternal hypertension, preeclampsia is sometimes characterized by either excess protein in the urine, fluid retention, or end-organ dysfunction.

Premature Birth: A baby born before 39 weeks of gestation. Due to their underdeveloped bodily systems and difficulty handling life outside the womb, premature babies are at increased risk for complications including intracranial hemorrhages (brain bleeds), breathing problems, hypoxic ischemic encephalopathy (HIE), cerebral palsy, periventricular leukomalacia (PVL), intellectual and developmental disabilities (I/DD) and more. Most babies born after 28 weeks gestation do not have long-term disabilities from prematurity alone.

See also: Betamethasone; Birth Injury; Birth Trauma; Cerebral Palsy; Hypoxic Ischemic Encephalopathy (HIE); Incompetent Cervix; Magnesium Sulfate Treatment; Neonatal Breathing Problems of Prematurity; Premature Rupture of Membranes (PROM); Progesterone; Tocolytics

Premature Rupture of Membranes (PROM): A complication in which a pregnant woman’s amniotic sac and chorion (the outermost fetal membrane) break before the onset of labor. In instances of prolonged PROM, the mother’s water breaks more than 18 hours before labor. In instances of premature PROM (PPROM), the mother’s water breaks before 39 weeks of gestation.

See also: Magnesium Sulfate Treatment; Premature Birth

Primitive Reflexes: Reflex actions originating in the central nervous system, including the crawl reflex, grasp reflex, tonic neck reflex, rooting reflex and step reflex. In normally developing babies, primitive reflexes are present for only the first couple months of life. Retention of primitive reflexes is often an early sign of cerebral palsy and developmental disabilities in infants.

See also: Cerebral Palsy; Crawling Reflex; Developmental Disabilities; Grasping Reflex: Postural Reactions; Rooting Reflex; Stepping Reflex; Tonic Neck Reflex

Progesterone: A synthetic or natural hormone used to reduce the risk of premature birth in women with short cervixes or histories of premature birth.

See also: Incompetent Cervix (Insufficient Cervix); Premature Birth

Protective Reactions: Postural reactions that protect the displaced body from falling. Delayed protective reactions are often an early sign of cerebral palsy and developmental delays in babies and young children.

See also: Cerebral Palsy; Developmental Delays; Equilibrium Reactions; Postural Reactions; Righting Reactions

Prothrombotic Coagulation Disorder: A blood clotting disorder sometimes found in children with hemiplegic cerebral palsy or MRI findings showing cerebral infarction.

See also: Cerebral Infarction; Hemiplegia (Hemiplegic Cerebral Palsy)

Q

Quadriparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which all four limbs are weakened or paralyzed due to neurological damage.

See also: Cerebral Palsy; Limb Involvement Classification System; Quadriplegia (Quadriplegic Cerebral Palsy); -paresis

Quadriplegia (Quadriplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which all four limbs are affected.

See also: Cerebral Palsy; Limb Involvement Classification System

R

Recreational Therapist: Therapeutic professionals who plan and coordinate recreational treatment for people with mental and physical disabilities.

Recreational Therapy: A therapeutic method that utilizes recreational activities in order to restore, improve and rehabilitate a patient’s functional ability. Examples of recreational therapy include sports therapy, animal-assisted therapy and art therapy.

See also: Recreational Therapy

Reduced Uteroplacental Perfusion (RUPP): A serious condition that affects blood flow between the mother and the fetus, causing harm to both. It reduces the flow of fluids (including blood) to the placenta and can cause hypoxic ischemic encephalopathy (HIE).

See also: Hypoxic Ischemic Encephalopathy (HIE); Placenta; Placental Insufficiency

Reflex Tests (Diagnosing Cerebral Palsy): Reflex tests, which are used to help diagnose cerebral palsy and developmental delays, monitor abnormal reflex development in babies. The persistence of primitive reflexes, irregular reflexes and developmental reflex delays often indicate cerebral palsy, neurological problems, developmental problems and brain damage.

See also: Cerebral Palsy; Developmental Delays; Diagnosis; Tonic Labyrinthine Reflex

Regional Anesthesia: Regional anesthesia is the loss of sensation in a region of the body produced by application of an anesthetic agent to all the nerves supplying that region (see spinal and epidural anesthesia).

See also: Anesthesia; Epidural Anesthesia; General Anesthesia; Spinal Anesthesia

Rehabilitation Engineer: Someone who uses science and principles to develop technological solutions and aid to the recovery of people with mental and physical disabilities.

Reperfusion Injury: An injury that occurs when blood rushes back too quickly to an area that has been oxygen-deprived. Here, the restoration of blood flow paired with the lack of oxygen and nutrients caused by the oxygen deprivation causes inflammation and oxidative damage to the tissue.

Resident Physician Fatigue: Performance problems associated with fatigue, sleep deprivation and overworking among medical personnel. Anxiety, depression, exhaustion and other side effects of sleep deprivation increase a medical professional’s chances of performing negligently.

See also: The July Effect; Medical Malpractice, Negligence (Medical Negligence)

Righting Reactions: Postural reactions that maintain alignment of the head, upper body and lower body. Delayed righting reactions are often an early sign of cerebral palsy and developmental delays in babies and young children.

See also: Cerebral Palsy; Developmental Delays; Equilibrium Reactions; Postural Reactions; Protective Reactions

Rigidity: Abnormal muscular stiffness.

See also: Cerebral Palsy; Muscle Tone

Rooting Reflex: A primitive reflex in which an infant’s mouth opens in response to touching sensations on the cheek or mouth. Retention of the rooting reflex beyond the first four months of life can be a sign of cerebral palsy and developmental disabilities in a baby.

See also: Primitive Reflexes

Rubella: A contagious viral infection that causes a distinctive red rash. It is preventable by vaccination. In a baby or fetus, rubella can lead to dangerous and permanent injuries, disabilities and health complications.

S

Sarnat Classification: See Sarnat Staging

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

Sarnat Grading Scale: See Sarnat Staging

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

Sarnat Score: See Sarnat Staging

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

Sarnat Stage I (Mild HIE): The least severe classification of hypoxic ischemic encephalopathy (HIE) as determined on the Sarnat Grading Scale. Characteristics of Sarnat Stage I HIE (mild HIE) include hyper-alert consciousness, normal muscle tone, normal activity, overactive stretch reflexes, mild distal flexion, weak sucking reflex, strong startle reflex, slight tonic neck reflex, no seizure activity, dilated pupils and tachycardia.

See also: Hypoxic Ischemic Encephalopathy (HIE); Mild Hypoxic Ischemic Encephalopathy (HIE); Sarnat Staging

Sarnat Stage II (Moderate HIE): The middlemost severe classification of hypoxic ischemic encephalopathy (HIE) as determined on the Sarnat Grading Scale. Characteristics of Sarnat Stage II HIE (moderate HIE) include lethargy, mild hypotonia (decreased muscle tone), decreased activity, strong distal flexion, overactive stretch reflexes, weak or absent suck reflex, weak startle reflex, strong tonic neck reflex, miosis (constriction of the pupil), bradycardia and seizure activity.

See also: Hypoxic Ischemic Encephalopathy (HIE); Moderate Hypoxic Ischemic Encephalopathy (HIE); Sarnat Staging

Sarnat Stage III (Severe HIE): The most severe classification of hypoxic ischemic encephalopathy (HIE) as determined on the Sarnat Grading Scale. Characteristics of Sarnat Stage III HIE (severe HIE) include coma or near-unconsciousness, absent activity, severely decreased muscle tone, intermittent decerebration of posture, decreased or absent stretch reflexes, absent suck reflex, absent startle reflex, absent tonic neck reflex, abnormal pupil activity, uncommon seizure activity and variable heart rate.

See also: Hypoxic Ischemic Encephalopathy (HIE); Sarnat Staging; Severe Hypoxic Ischemic Encephalopathy (HIE)

Sarnat Staging (Sarnat Grading Scale; Sarnat Classification): A system used to classify hypoxic ischemic encephalopathy (HIE) into three levels (“stages”) based on severity. Sarnat staging uses EEG and clinical findings to determine if a baby has Mild HIE (Sarnat Stage I), Moderate HIE (Sarnat Stage II), or Severe HIE (Sarnat Stage III). Mild, moderate and severe brain damage from HIE can occur with any Sarnat stage or score.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy

Scissor Gait: A gait abnormality characterized by a gait pattern in which the hips and pelvis are locked, the ankles are turned inwards, the feet make contact with the ground at the ball of the foot, the knees and thighs cross and the arms reach outwards for balance. The scissor gait is largely associated with spastic cerebral palsy.

See also: Cerebral Palsy; Gait Abnormality; Spastic Cerebral Palsy

Secondary Energy Failure: A delayed form of brain damage that happens after an initial oxygen-depriving event. Secondary energy failure after hypoxia–ischemia makes brain damage and functional impairment significantly worse. This energy failure can be delayed hours after the initial incident and can occur during a seeming recovery.

Sepsis (Neonatal Sepsis): A potentially dangerous and life-threatening immune response triggered by infection, in which the patient has an infection in the bloodstream. Untreated, neonatal sepsis can cause seizures, septic shock, meningitis, brain damage and cerebral palsy.

See also: Meningitis

Seizures: Involuntary convulsions that are triggered by abnormal electrical discharges in the brain or problems related to the brain’s chemistry. Seizures can cause involuntary jerking movements lasting from a few seconds to a few minutes and can affect normal brain functioning and consciousness. Seizures must be immediately diagnosed and properly treated in newborns in order to prevent permanent damage to the baby. Newborn seizures often indicate serious neurological damage from birth-related injuries.

See also: Clonic Seizures; Epilepsy

Selective Dorsal Rhizotomy (SDR): A surgical procedure that reduces spasticity in patients with cerebral palsy. During the procedure, surgeons carefully test the nerves that lead to and from spastic muscles in the legs. Nerves with abnormal nerve branches are cut to reduce spasticity.

See also: Cerebral Palsy; Treatment

Septic Shock: Septic shock occurs when a baby develops sepsis (an infection in the bloodstream) and the sepsis progresses to severe sepsis. Without quick diagnosis and treatment, septic shock can cause low blood pressure, organ failure, brain damage and/or death.

See also: Sepsis (Neonatal Sepsis)

Settlement: In law, a settlement is the formal resolution of a lawsuit between disputing parties that takes place without proceeding to a final court judgment.

See also: Verdict

Severe Cerebral Palsy: A classification of cerebral palsy based on the severity of impairments. Those with severe cerebral palsy require extensive help from assistive technology, adaptive equipment and other people in order to complete daily tasks.

See also: Cerebral Palsy; Severity (Classification of Cerebral Palsy)

Severe Hypoxic Ischemic Encephalopathy (HIE) (Sarnat Stage III): The most severe classification of hypoxic ischemic encephalopathy (HIE) as determined on the Sarnat Grading Scale. Characteristics of severe HIE include coma or near-unconsciousness, absent activity, severely decreased muscle tone, intermittent decerebration of posture, decreased or absent stretch reflexes, absent suck reflex, absent startle reflex, absent tonic neck reflex, abnormal pupil activity, uncommon seizure activity and variable heart rate.

See also: Asphyxia; Birth Asphyxia; Hypoxic Ischemic Encephalopathy (HIE); Intrapartum Asphyxia; Neonatal Encephalopathy; Sarnat Staging

Severity (Classification of Cerebral Palsy): A classification system for cerebral palsy in which a patient’s case is classified on the general extent of impairment. According to this system, cerebral palsy is classified as mild, moderate, or severe.

See also: Cerebral Palsy

Shaken Baby Syndrome (Abusive Head Trauma): A serious neonatal brain injury resulting from the violent shaking of a baby or another form of head trauma. Shaken Baby Syndrome typically, although not always, indicates child abuse.

Short Umbilical Cord: An umbilical cord that is shorter than 35 centimeters at term. Normal umbilical cord length is 50-70 centimeters long.

See also: Umbilical Cord; Placental Abruption

Shoulder Dystocia: A delivery complication in which additional obstetrical maneuvering is required to deliver a baby whose shoulders are stuck in the vaginal canal. Typically, the baby’s shoulder is stuck behind a symphysis pubis bone in the mother’s pelvis. In cases of shoulder dystocia, the excessive force or traction by the caregiver can cause permanent injury and disability.

See also: Brachial Plexus Injury (BPI); Erb’s Palsy

Sickle Cell Anemia: A red blood cell disorder that affects hemoglobin, or the protein that carries oxygen throughout the body. Maternal sickle cell anemia is a known cause of fetal growth restriction (intrauterine growth restriction).

See also: Fetal Growth Restriction (FGR); Intrauterine Growth Restriction (IUGR)

Sign; Clinical Sign: Signs of a health problem can be detected, measured and confirmed by medical professionals in a clinical setting. For example, seizures are a clinical sign of neurological damage because they can be measured by medical professionals.

See also: Diagnosis; Symptom

Skull Fracture (Cranial Fracture): An injury in which any one of the skull bones is broken or pushed. Neonatal skull fractures can occur as the result of a traumatic birth due to the extreme mechanical or natural forces of labor and delivery.

See also: Birth Trauma; Depressed Skull Fracture; Intracranial Hemorrhages (Brain Bleeds); Linear Skull Fracture; Occipital Osteodiastasis

Spastic Cerebral Palsy: A type of cerebral palsy based on the motor disturbance classification system. Spastic CP is the most common type of cerebral palsy, occurring in 70% to 80% of all cases. Those with spastic cerebral palsy have hypertonia (extreme muscular tension), involuntary muscular contractions, spasms and tightness.

See also: Cerebral Palsy; Hypertonia; Motor Disturbance Classification System; Spasticity; Scissor Gait

Spastic Diplegia: A classification of cerebral palsy characterized by (1) spasticity and (2) involvement in two limbs on opposite sides of the body, with the legs more affected than the arms.

See also: Spastic cerebral palsy, spasticity, Diplegia (Diplegic Cerebral Palsy)

Spastic Monoplegia: A classification of cerebral palsy characterized by (1) spasticity and (2) involvement in one limb.

See also: Spastic cerebral palsy, spasticity, Monoplegia (Monoplegic Cerebral Palsy)

Spastic Pentaplegia: A classification of cerebral palsy characterized by (1) spasticity and (2) involvement in four limbs, as well as the head and neck.

See also: Spastic cerebral palsy, spasticity, Pentaplegia (Pentaplegic Cerebral Palsy)

Spastic Quadriplegia: A classification of cerebral palsy characterized by (1) spasticity and (2) involvement in four limbs.

See also: Spastic cerebral palsy, spasticity, Quadriplegia (Quadriplegic Cerebral Palsy)

Spastic Triplegia: A classification of cerebral palsy characterized by (1) spasticity and (2) involvement in three limbs.

See also: Spastic cerebral palsy, spasticity, Triplegia (Triplegic Cerebral Palsy)

Spasticity: A musculoskeletal abnormality characterized by hypertonia (abnormally stiff muscles), tightness, spasms and involuntary muscular contractions. Spasticity is caused by abnormal signals from the central nervous system and is typically the result of brain damage.

See also: Cerebral Palsy; Hypertonia; Motor Disturbance Classification System; Spastic Cerebral Palsy; Scissor Gait

Spasticity (Classification of Cerebral Palsy): A classification system that divides cases of cerebral palsy into spastic and non-spastic types.

See also: Cerebral Palsy; Non-Spastic Cerebral Palsy; Spastic Cerebral Palsy

Speech and Language Therapy: A therapeutic method that helps patients improve and restore communication, language and oral abilities including speaking, communicating, eating, swallowing and more.

See also: Speech Deficits; Speech Pathologist; Therapy

Speech Deficits: An impairment of words, language, the physicality of the tongue, mouth or vocal chords, or the neurological capability of sending language to the brain or mouth.

See also: Developmental Delays

Speech Pathologist: Someone who assesses, diagnoses, treats and helps patients who have speech, language and swallowing disorders.

See also: Speech Deficits; Speech and Language Therapy

Spinal Anesthesia (Spinal Block, Subarachnoid Block, Intradural Block; Intrathecal Block): Spinal anesthesia is a form of regional anesthesia involving the injection of a local anesthetic into the subarachnoid space, generally through a fine needle.

See also: Anesthesia; Epidural Anesthesia; General Anesthesia; Regional Anesthesia

Sports Therapy: Therapy involving sports. Children with cerebral palsy and other disabilities from birth injuries may benefit from sports therapy, as it targets and improves physical fitness and movement in a fun, engaging way. Examples of sports therapy include cycle therapy, ski therapy, aquatic therapy and more.

See also: Recreational Therapy; Therapy

Standard of Care (Care Standards): The level at which medical professionals are legally and professionally obligated to perform. When a medical professional breaches duty in any way, it is considered a violation of the standard of care. Violation of care standards is an element of medical malpractice litigation that allows plaintiffs to recover damages.

See also: Birth Injury; Birth Trauma; The July Effect; Medical Malpractice (Medical Negligence); Resident Physician Fatigue

Staphylococcus (Staph) Infections: An infection caused by a bacterium called Staphylococcus aureus. While skin infections are the most common manifestation (similar in appearance to pimples or boils) of Staph infections, pneumonia, food poisoning, blood poisoning and toxic shock syndrome are also possible outcomes. Staph infections are easily treatable with antibiotics.

Statute of Limitations (SOL): A federal or state law that states the maximum amount of time a person can wait before filing a lawsuit. Statutes of limitation vary by state and type of case.

Stem Cell Therapy: A therapeutic method in which stems cells, which are taken from umbilical cord blood, are used to repair and regenerate injured cells. Stem cell therapy shows great potential for decreasing inflammation and repairing the injured brain cells in patients with cerebral palsy, birth-related brain injuries and neurological damage.

See also: Therapy

Stepping Reflex: A primitive reflex in which an infant moves his or her legs in stepping movements when held upright. Retention of the stepping reflex beyond the first few weeks of life can be a sign of cerebral palsy and developmental disabilities in a baby.

See also: Primitive Reflexes

Strabismus: A vision condition characterized by misalignment of the eyes. When someone has strabismus, an imbalance of eye muscles causes one or both of the eyes to turn out, in, up or down. Strabismus is a common side effect of spastic cerebral palsy.

See also: Cerebral Palsy; Spastic Cerebral Palsy; Visual Impairment

Strong Contractions: Prolonged and/or arrested periods of contractions. Strong contractions often result in fetal distress. Common causes of strong contractions include fetal size and presentation abnormalities.

See also: Cytotec; Emergency C-Section; Fetal Distress; Hyperstimulation; Hypertonicity; Pitocin; Tachysystole

Subarachnoid Hemorrhage: A type of intracranial hemorrhage in which bleeding occurs in the subarachnoid space, which is the area between the innermost of the two membranes that cover the brain. This brain bleed typically occurs in full term babies and causes seizures, apnea and lethargy. Subarachnoid hemorrhages are typically caused by birth trauma.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subdural Hemorrhage; Subgaleal Hemorrhage

Subdural Hemorrhage / Subdural Hematoma (Brain Bleed): A type of intracranial hemorrhage in which one or more ruptures occur in the subdural space, which is the area between the brain’s surface and the thin layer that separates the brain from the skull. Subdural hemorrhages are typically caused by difficult delivery and head trauma, and they often result in seizures, hyperbilirubinemia, head enlarging, Moro reflex problems and retinal hemorrhages.

Difficult deliveries and birth trauma typically cause subdural hemorrhages.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subgaleal Hemorrhage

Subgaleal Hemorrhage (Brain Bleed): Bleeding between the skull and the scalp that is most often caused by vacuum extractors used on a baby’s head during delivery.

See also: Brain Bleed; Birth Trauma; Cephalohematoma (Cephalhematoma); Cerebral Hemorrhage; Hematoma; Intracranial Hemorrhage; Intraventricular Hemorrhage; Subarachnoid Hemorrhage; Subdural Hemorrhage

Subtle Seizures: A classification of neonatal seizures. Subtle seizures are characterized by subtle features, which may include gaze fixation, repetitive facial movements and a bicycling motion of the legs. Subtle seizures occur in about 50% of all neonatal seizures, making them the most common type.

See also: Epilepsy; Seizures

Suit Therapy (Intensive Suit Therapy): A therapeutic method in which participants wear an orthotic suit designed to aid and improve musculoskeletal movement, control, coordination, flexibility and function. Suit therapy is also known as intensive suit therapy, Adeli suit therapy and NeuroSuit therapy. Many individuals with cerebral palsy and other neuromuscular impairments benefit from suit therapy.

See also: Alternative Therapy; Cerebral Palsy; Complementary Therapy; Physical Therapy; Therapy

Surfactant: A medication given to premature babies to help their immature lungs breathe easier. Pulmonary surfactant greatly reduces surface tension, increasing compliance and allowing the lung to inflate much more easily, thereby reducing the work of breathing. It reduces the pressure difference needed to allow the lung to inflate.

Symptom: Symptoms are factors noticed by an individual that indicate a medical condition, injury or health complication. Unlike clinical signs, symptoms are solely based on a patient’s personal experience of his or her medical condition. For example, fatigue, nausea and irritability are symptoms of a condition.

See also: Diagnosis; Sign (Clinical Sign)

Syphilis: A sexually transmitted infection that can be transmitted to a fetus in utero. Bacterial infections can cause the disease. If it is left untreated, it can be fatal and spread to various organs in the body.

See also: Maternal Infections

Systemic Lupus Erythematosus: An autoimmune disease in which the body’s immune system attacks healthy tissue. It can affect the brain, joints, kidneys, skin and other organs. In an expectant mother, it can cause intrauterine growth restriction (IUGR).

See also: Intrauterine Growth Restriction (IUGR)

T

Tachycardia: An abnormally fast heart rate, with values over 160 BPM. Tachycardia typically indicates fetal distress, a dangerous complication that necessitates a rapid delivery. Failure to quickly deliver a baby with tachycardia can cause hypoxic ischemic encephalopathy (HIE), brain damage, and permanent injury and disability.

See also: Bradycardia; Cytotec; Fetal Distress; Pitocin

Tachysystole (Uterine Hyperstimulation): A dangerous labor and delivery complication in which uterine contractions occur excessively or abnormally. Tachysystole can limit blood flow through the umbilical cord, thereby causing serious fetal oxygen deprivation and birth injury.

See also: Cytotec; Hyperstimulation; Pitocin; Hypertonicity; Strong Contractions

Tendon Release Surgery (Tenotomy): A surgical procedure that involves cutting through tendons (tenotomy) to improve range of motion. Typically performed on the calf or inner thigh muscles, tendon release surgery involves cutting the tendon and allowing it to retract towards the junction of the muscle and tendon. It is often performed on people with contractures, spasticity and cerebral palsy.

See also: Cerebral Palsy; Contractures; Selective Dorsal Rhizotomy (SDR); Spastic Cerebral Palsy; Spasticity

Therapeutic Electrical Stimulation Therapy (TES): A form of therapy in which neurostimulation is used to build muscle in patients with neuromuscular and movement impairments. Electrical impulses cause the muscles to contract, supporting muscle growth.

See also: Complementary Therapy; Therapy

Therapeutic Horseback Riding (Equine-Assisted Therapy): Any therapeutic method utilizing a horse to achieve rehabilitation goals.

See also: Hippotherapy; Recreational Therapy

Therapy: Therapy is one specific form of treatment geared towards relieving, restoring, improving or healing any medical condition or disorder. Some of the most common forms of therapy for children with birth injuries include physical therapy, occupational therapy, speech-language therapy and recreational therapy.

See also: Treatment

Thrombocytopenia: A condition characterized by a low amount of blood platelets (colorless blood cells that aid blood clotting). This condition leads to bruising, bleeding in the tissues and blood clotting. Thrombocytopenia often happens as a result of other disorders, such as leukemia and immune system problems. A baby with thrombocytopenia should be delivered between 34 and 39 weeks to prevent intracranial hemorrhages (brain bleeds).

See also: Intracranial Hemorrhages

Tocolytics (Tocolytic Agent): Medications used to prevent premature birth.

See also: Betamethasone; Incompetent Cervix (Insufficient Cervix); Premature Birth; Premature Rupture of Membranes (PROM)

Tonic Labyrinthine Reflex (TLR): A primitive reflex found in newborns. When babies tilt their heads back from a supine position, the TLR causes stiffening and arching of the back, extension and stiffening of the legs, pointing of the toes, bending of the elbows and curling of the fingers. The presence of the TLR beyond the first 6 months of life may indicate that the child has cerebral palsy.

See also: Cerebral Palsy; Developmental Delays; Diagnosis; Reflex Tests

Tonic Neck Reflex (Asymmetrical Tonic Neck Reflex): A primitive reflex found in newborns. When a baby’s head turns, the arm extends on the side to which the head is turned. Retention of the tonic neck reflex beyond the first few weeks of life can be a sign of cerebral palsy, neurologic disorder and developmental disabilities in a baby.

See also: Primitive Reflexes

Tonic Seizures: A classification of neonatal seizures characterized by increased bodily tone, stiff muscles, interrupted breathing and eye rolling. Tonic seizures happen during the night, involve most of the brain and affect both sides of the body. They occur in 5% of all cases of neonatal seizures.

See also: Epilepsy; Seizures

Toxoplasmosis: A disease that results from the Toxoplasma parasite. Over 60 million men, women and children carry the parasite, but healthy immune systems are able to keep it from causing serious illness. It is critical to prevent the infection in pregnant women and neonates. Toxoplasmosis can cause fetal growth restriction (FGR) in a fetus.

See also: Fetal Growth Restriction (FGR); Intrauterine Growth Restriction (IUGR); Maternal Infections

Tracheal Intubation: Placement of a plastic tube into the trachea, or windpipe, in order to keep an airway open. It is commonly used in asphyxiation cases where the airway is obstructed.

Transvaginal Mesh: A surgical technique where a piece of plastic is implanted through the vagina to fix pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

Treatment: In medicine, the act or process of providing care for a patient with an injury, illness or health condition.

See also: Therapy

Tremor: An involuntary, shaking muscle movement that is often a sign of a neurological disorder. Coordination and movement in the hands, arms, head, face, voice and legs are most often affected.

See also: Cerebral Palsy

Triparesis: A classification of cerebral palsy based on the Limb Involvement Classification System in which three limbs are weakened or paralyzed due to neurological damage.

See also: Cerebral Palsy; Limb Involvement Classification System; Triplegia (Triplegic Cerebral Palsy); -paresis

Triplegia (Triplegic Cerebral Palsy): A classification of cerebral palsy based on the Limb Involvement Classification System in which three limbs are affected.

See also: Cerebral Palsy; Limb Involvement Classification System

True Knot: A knot that forms in the baby’s umbilical cord. Knots occur in about 1 in every 100 pregnancies and 1 of every 2,000 deliveries. In most cases, true knots happen with monoamniotic twins, or identical twins that share the same amniotic sac.

See also: Umbilical Cord; Umbilical Cord Compression; Umbilical Cord Prolapse; Nuchal Cord; Short Umbilical Cord

Twin-to-Twin Transfusion Syndrome (TTTS): A serious obstetric complication that occurs when the blood vessels of two twin fetuses are connected and one fetus receives more blood flow from the shared placenta than the other. Without prompt treatment, TTTS can cause serious birth injuries and/or fetal death.

See also: Multiple Gestation

U

Ultrasound (Ultrasonography): A method of using high-frequency sound to create an image either prenatally or after birth. Through prenatal ultrasound testing, medical personnel are able to see internal organs and tissues including a mother’s unborn baby, estimate fetal weight and gestational age, assess amniotic fluid levels and diagnose IUGR and macrosomia. Ultrasonography used on a baby’s brain after birth can help to detect abnormalities, cystic periventricular leukomalacia (PVL), hypoxic ischemic encephalopathy (HIE), intracranial hemorrhages, cerebral edema and more.

See also: Diagnosis; Doppler Flow

Umbilical Cord: A cord that connects the fetus with the placenta of the mother. It transports blood, oxygen and nutrients from the mother to the fetus and carries waste from the fetus. Any interference with the umbilical cord’s function is dangerous and can result in serious, permanent birth injuries.

See also: Nuchal Cord; Short Umbilical Cord; True Knot; Umbilical Cord Blood Gas Test; Umbilical Cord Compression; Umbilical Cord Prolapse

Umbilical Cord Blood Gas Test: Blood gas tests are a measurement of how much oxygen and carbon dioxide are in the blood. They also determine the acidity (pH) of the blood. Just after a baby is born, blood gas testing of umbilical cord blood can be performed to determine the health of a baby at birth. To determine if a baby has experienced an oxygen-depriving injury (a hypoxic-ischemic or anoxic event), it is best to examine acidity in the umbilical artery blood in order to determine if anaerobic metabolism occurred. Anaerobic metabolism indicates that an instance of oxygen deprivation occurred.

See also: Birth Asphyxia; Diagnosis; Hypoxic Ischemic Encephalopathy (HIE); Umbilical Cord

Umbilical Cord Compression: A potentially dangerous obstetrical complication in which the umbilical cord is compressed by pressure that decreases or obstructs the flow of blood, oxygen and nutrients to the baby.

See also: Umbilical Cord; Umbilical Cord Compression; Umbilical Cord Prolapse; Nuchal Cord; True Knot; Short Umbilical Cord

Umbilical Cord Prolapse: When the umbilical cord presents before or with the baby during delivery. A cord prolapse is a dangerous and emergency situation in labor and delivery that interferes with the flow of blood, nutrients and oxygen to the baby. Without timely delivery, a cord prolapse can cause severe, permanent birth injuries including hypoxic ischemic encephalopathy (HIE). Emergency Cesarean section is typically required.

See also: Umbilical Cord; Umbilical Cord Compression; True Knot; Short Cord

Unilateral Cerebral Palsy: Cerebral palsy affecting one side of the brain.

See also: Monoplegia, Spastic Monoplegia, Hemiplegia

Urinary Tract Infections (UTI): An infection of any of the body’s urinary systems, which include the kidneys, bladder, ureters and urethra. Untreated UTIs can cause dangerous and permanent birth injuries and obstetrical complications including intrauterine infection, premature birth, brain damage and neonatal infection.

See also: Maternal Infections

Uterine Atony: When the uterus does not effectively contract after the delivery of a baby. Uterine atony could lead to a postpartum hemorrhage (PPH).

Uterine Rupture: An emergency pregnancy complication in which the uterus tears, potentially expelling the unborn baby into the mother’s abdomen. Uterine rupture often results in hemorrhaging, premature rupture of the membranes (PROM), partial or full delivery into the abdominal cavity, and without timely delivery can cause a baby to suffer birth asphyxia and hypoxic ischemic encephalopathy (HIE).

Uteroplacental Insufficiency (Placental Insufficiency): An obstetrical complication characterized by the lack of adequate blood flow to the baby from the mother. Uteroplacental insufficiency can cause intrauterine growth restriction (IUGR), hypoxic ischemic encephalopathy (HIE), cerebral palsy, seizures and brain damage.

V

Vacuum Extractors: A labor and delivery assistance device used for various reasons including fetal distress. In vacuum extraction deliveries, a small, soft cup is applied to the top and back of the baby’s head. A tube runs from the cup to a vacuum pump that provides suction. During a contraction, the physician pulls or applies gentle traction to the baby’s head while suction from the vacuum assists in pulling the baby’s head out of the birth canal. Misuse of vacuum extractors can cause dangerous and permanent birth injuries and neonatal brain damage.

See also: Forceps

Vaginal Birth After Cesarean (VBAC): The vaginal birth of a baby by a mother who has previously undergone a C-section operation.

See also: C-Section (Cesarean Section) Delivery

Vasa Previa: Vasa previa is a medically emergent condition in which the baby’s blood vessels are exposed and covering the opening to the birth canal. In normal uteroplacental circulation, the baby’s blood vessels travel within the umbilical cord and insert into the central region of the placenta. In vasa previa, some of the baby’s blood vessels travel within the fetal membranes and across the opening of the birth canal. Vasa previa can cause hemorrhaging, hypoxic ischemic encephalopathy (HIE), permanent brain damage and a number of associated disabilities from absent timely diagnosis and treatment.

Verdict: In law, a verdict is a decision made by a jury or trial on a given case.

See also: Settlement

Vertex Presentation (Cephalic Presentation): The standard fetal presentation. In vertex presentation, the crown of the baby’s head presents first through the birth canal.

See also: Breech Presentation (Breech Birth); Face Presentation; Fetal Position; Fetal Presentation; Malpresentation (of Fetus); Vertex Presentation

Villitis: Inflammation of the chorionic villi surface of the placenta. Chorionic villi develop to maximize surface area contact with maternal blood for nutrient and gas exchange with fetal blood. Villitis may be dangerous and, without proper management and diagnosis, can lead to fetal health problems.

See also: Maternal Infections

Visual Impairment: Any limitation of eye function. Neonatal brain injuries, cerebral palsy and other birth injuries can lead to visual impairment. Strabismus, blindness and low vision are a few examples of visual impairments.

See also: Ophthalmologist; Strabismus

W

Weight Checks (Prenatal): Maternal weight measurements taken at routine prenatal visits. Abnormal maternal weight gain can indicate irregular fetal development and obstetrical complications.

See also: Fetal Growth Restriction (FGR); Intrauterine Growth Restriction (IUGR)

White Matter: The brain’s white matter helps transmit messages throughout the largest part of the brain. White matter is made of axons connecting different parts of gray matter to each other. To use an analogy, gray matter is like computer chips in the brain and the white matter is the circuitry connecting those computer chips. White matter death occurs in cases of periventricular leukomalacia (PVL), hypoxic ischemic encephalopathy and birth trauma.

See also: Gray Matter (of the brain); Periventricular Leukomalacia (PVL)

X

Y

Yoga: A system of exercises used to improve bodily and mental well-being. Many individuals with cerebral palsy or other physical limitations choose to use yoga as a form of complementary and alternative therapy.

See also: Alternative Therapy; Cerebral Palsy; Complementary Therapy