- September 16, 2019
Doctors throw a lot of highly technical terms around right after a birth, but if you hear the phrase “fetal acidosis” you should listen up. Caused by a lack of oxygen, acidosis occurs when carbonic acid (formed from excess CO2) builds up in the fetus’ blood rather than being passed back to the mother in exchange for oxygenated blood. When too much carbonic acid builds up, the baby’s blood pH will drop. This may be a sign of a birth injury that can have lifelong effects.Chronic vs. Acute Acidosis
Chronic acidosis, or long-term deprivation of oxygen flow, may be caused by a variety of maternal health complications, but acute acidosis occurs during labor and generally has a relatively quick onset. If it is also resolved quickly the baby may not suffer any damage, as humans have evolved to survive a relatively difficult labor process. Even instances of severe asphyxiation may not have a lasting impact if they are brief enough. Due to this quirk of fetal adaptability, an acidosis reading may not help doctors predict whether the baby has sustained brain damage. But, permanent damage may occur when acidosis is prolonged for over 30 minutes.
All babies have a lower blood pH at birth, so a small fluctuation from humans’ baseline pH should not concern you. Acidosis refers to readings below a set range (7.20 – 7.24) that may signal oxygen deprivation. If your doctor notes acidosis in the umbilical artery but not the umbilical vein, you are likely looking at a case of acute acidosis. If the acidosis is present and equal in both areas, acidosis (and oxygen deprivation) likely persisted for an extended period of time before birth.
Diagnosing Acidosis During and After Birth
The easiest way to identify acidosis is after delivery—but doctors can use a fetal heart rate monitor to identify signs of asphyxiation or other fetal distress during labor. The fetal heart rate should be fast and uneven; a steady, sedate pattern is a sign that the fetus is not getting enough oxygen. Directly after birth, doctors use a measure called the Apgar score to determine blood oxygen and acidosis. The system evaluates:
- The complexion: A healthy baby will be pink; grey or blue skin can signal lack of oxygen
- Pulse rate: The baby’s heart rate should be above 100 BPM
- Reflexes: A baby should have strong reactions (cries, movement) when tested
- Muscle tension: A baby’s arm and leg muscles should be tight, and it should not be easy to extend their limbs
- Breathing: The baby should have a loud cry
If your baby shows deficits in more than one of these areas, they may have acidosis. Critical readings in more than one category typically signal the need for increased monitoring or intervention.
What Causes Acute Fetal Acidosis?
Acute Cord Compression
Because nutrients and oxygen flow to a baby through the umbilical cord, any damage or flow blockage endangers the baby’s health. Also called Umbilical Cord Prolapse or UCP, this condition can be visually diagnosed and is usually accompanied by atypical fetal heart rate readings. If noticed, the baby must be delivered as quickly as possible—most doctors allow a thirty-minute window for either an emergency C-section or a vaginal birth expedited by instruments. Doctors may also bring in a team to help alleviate the damage or threat to the umbilical cord until the delivery has been completed.
Contraction Irregularities
Uterine contractions that are less than 2-3 minutes apart or that last longer than 90 seconds may endanger your baby by cutting off its oxygen flow. Blood in the uterus carries oxygen to the fetus—and when contractions tighten the blood vessels, its flow is reduced or even halted. If a pattern of quick or excessively forceful contractions lasts longer than a few minutes, doctors should intervene to ensure infant health.
Placental Abruption
Your placenta is responsible for passing nutrients and oxygen to the fetus during pregnancy. When it separates from the wall of your uterus before the baby’s birth, this is referred to as an abruption.
It may happen during your third trimester or during labor—and it is both a painful and dangerous condition. If the placenta moves too far from the wall of your uterus, it will no longer be able to shuttle nutrients and oxygen to your baby. Mild abruptions are not a cause for worry, as there is still enough connection between the placenta and your circulatory system to maintain a proper flow of blood to and from the fetus. However, more severe abruptions may require emergency intervention; if deprived of nutrients and oxygen for too long, a baby may develop brain damage or even die in the womb. As with acute cord compression, an accelerated delivery may be necessary to prevent ill effects.
Is Your Baby Suffering After Acidosis?
Though doctors are unsure whether it is the lack of oxygen or the decrease in pH that cause lasting symptoms after a case of acidosis, your baby may suffer from developmental defects if your doctor did not mount a swift response. Goodman Acker, P.C. works nonstop to help our clients recover after difficulties caused by medical malpractice.
If your baby was diagnosed with acidosis after birth and subsequently showed signs of brain damage, don’t wait to see if you have a case. The lasting developmental difficulties that result from oxygen deprivation could affect you and your family for decades to come. Talk to our team if you are considering asking for a settlement to help offset the challenges ahead of you.
Contact us online or call (248) 286-8100 for your free consultation today.