What causes cerebral palsy?

Cerebral palsy is caused by an injury to the baby’s brain which occurs before, during or immediately after birth. If the injury was caused by negligent medical, maternity or neonatal care, or if the cause was an event which should have been avoided with appropriate care, the injured child may have a claim.


    How can cerebral palsy be caused?

    There are a number of ways in which cerebral palsy can be caused, many of these through medical negligence, they include:

    Lack of oxygen

    Permanent brain damage can be caused through a lack of oxygen to the brain either during or around the time of birth. This is often described as hypoxia, hypoxic ischaemic encephalopathy (HIE), asphyxia or anoxia.




    Infections which can potentially cause cerebral palsy include maternal infection during pregnancy (such as Group B Strep or GBS), infection through premature or prolonged rupture of membranes (PROM) or neonatal meningitis.


    Group B Strep (GBS)

    One in every 2,000 newborn babies in the UK and Ireland are diagnosed with GBS. The infection is common, and is not a sexually transmitted disease, and will probably have been harmless to the baby’s mother. However, at this early stage, before the newborn baby has developed their immune system, group B strep infection must be diagnosed and treated quickly if more serious complications are to be avoided.

    Delayed diagnosis and treatment of GBS infection in a newborn baby can lead to life-threatening conditions, including septicaemia, pneumonia and meningitis. One in ten babies born with group B strep die from the infection. Of those who survive GBS infection, one in every five babies is left permanently disabled by its complications, such as cerebral palsy, blindness, deafness or a serious learning disability.

    With prompt diagnosis and treatment, most GBS babies make a good recovery.



    Neonatal meningitis is a serious, disabling and potentially life-threatening condition affecting around 300 babies in the UK each year. Urgent hospital treatment with antibiotics is essential to avoid serious complications. With swift treatment many babies make a good recovery however if there is a delay in diagnosis or treatment of neonatal meningitis then permanent damage to the brain and nerves may already have occurred. The child can be left with a permanent disability such as cerebral palsy.



    Prolonged rupture of the membranes (PROM)

    Rupture of the membranes (or waters breaking) is a natural process which usually occurs around the start of labour when the pregnancy has reached full term (37 or more weeks). In some cases, rupture of the membranes takes place before labour begins (pre-labour) or before the pregnancy has reached term (pre-term pre-labour).

    From the time that the mother’s waters have broken, the unborn baby is at risk of chorioamnionitis, an infection which can be caused by bacteria ascending from the mother into the uterus where it can affect the baby. The infection risk to the baby increases with time and is, therefore, greater where there has been a prolonged time-lapse between rupture of membranes and delivery. In such cases, the pregnant woman should be carefully monitored for signs of infection, such as high temperature or uterine tenderness, and offered antibiotics if necessary. The unborn baby should also be monitored regularly to check on their wellbeing and ensure its safe delivery.

    Failure to diagnose or act on signs of a chorioamnionitis infection could result in permanent brain damage to the child, such as cerebral palsy.


    Kernicterus brain damage (from untreated jaundice)

    If there is a delay in diagnosis or treatment of jaundice then babies can develop kernicterus. This brain damage results in permanent neurological disability and dysfunction known as bilirubin encephalopathy. Longer term disabling effects of kernicterus include cerebral palsy, impaired hearing and learning disabilities.



    Brain damage caused by untreated hypoglycaemia

    Whilst permanent brain damage caused by hypoglycaemia is rare there have been incidents where we have seen delays in testing/referral/admission, delays in administering glucose or failure to properly advise parents.



    Complications of twin pregnancies including twin to twin transfusion (TTTS)

    Twin pregnancies, as with all multiple pregnancies, carry greater risks for the mother and baby than ‘singleton’ pregnancies. 

    Having twins increases the risk of many of the complications of pregnancy, such as intrauterine growth restriction (IUGR), pre-eclampsia, and gestational (pregnancy-related) diabetes. Twin pregnancies also have complications of their own.

    During antenatal care, labour and delivery, and in the neonatal period immediately after birth, twin pregnancies should be treated as high risk. Twin births need careful planning to ensure that delivery takes place in a way that is best for the mother and babies’ safety with skilled obstetric care available to manage the delivery.

    Regular scanning and monitoring must take place to ensure that complications are detected early. This includes electronic fetal heart monitoring during labour and delivery. With correct care, additional scanning and monitoring in pregnancy, proper advice and planning the method of delivery for the birth, and correct and skilled management of labour and delivery, many of the risks of twin pregnancy can be managed or avoided.



    Bleeding within the baby’s brain

    Bleeding within the baby’s brain can be caused by trauma from a forceps or vacuum delivery, haemorrhagic disease from a Vitamin K deficiency or intra-ventricular haemorrhage (IVH).

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