Massive Subaponeurotic Haemorrhage in Infants Born by Vacuum Extraction

Ahuja, Gupreet; Willoughby, M. L. N.; Kerr, Murray; Hutchison, John A.

doi:10.1136/bmj.3.5673.743

Cited by 55 publications

(26 citation statements)

References 10 publications

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“…In the studies of Ahuja (24) and Lehman (45), almost all the cases were noted in primigravidas. Fahmy (46), however, found no association between parity and the risk of developing subgaleal hemorrhage.…”

Section: Other Factorsmentioning

confidence: 96%

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Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Uchil¹,

Arulkumaran²

2003

Obstetrical & Gynecological Survey

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Subgaleal hemorrhage is a rare condition of the neonate often associated with instrumental delivery. It is a potentially fatal condition that is often underreported and underdiagnosed. The vacuum extractor is being advocated as the instrument of first choice for assisted vaginal delivery, but appears to be associated with an increased incidence of subgaleal hemorrhage. It is widely believed that the vacuum cup will dislodge before causing serious fetal trauma. Because of the ease of application, vacuum extractors could be used potentially in circumstances in which forceps would not be attempted, allowing an operator of average experience to perform rotational deliveries. The worrisome increase in the incidence of subgaleal hemorrhage associated with vacuum extraction leads to the issuance of warnings from governmental authorities in Canada and the United States. This review discusses the anatomy of this lesion, etiology, clinical presentation, management, and possible prevention.

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Section: Other Factorsmentioning

confidence: 96%

“…Although subgaleal hemorrhage can occur after spontaneous and forceps deliveries (22), the incidence has considerably increased since the introduction of the vacuum extractor into clinical practice (23,24). Earlier studies had suggested that the incidence of subgaleal hemorrhage with the vacuum extractor could be as high as 1% to 3.8% (25).…”

Section: Incidencementioning

confidence: 98%

Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Uchil¹,

Arulkumaran²

2003

Obstetrical & Gynecological Survey

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“…It is commonly associated with dif® cult delivery and the use of the vacuum extractor. 1,2 The extent and severity of the bleed vary. If the bleed is small and contained, the neonate may remain asymptomatic and recovery may be uneventful.…”

Section: Introductionmentioning

confidence: 98%

Subgaleal haemorrhage: risk factors and neurological and developmental outcome in survivors

Gebremariam¹

1999

Annals of Tropical Paediatrics

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To identify the risk factors associated with subgaleal haemorrhage and to assess the long-term neurological and developmental morbidity in survivors, data were prospectively collected over 5 years on 69 newborns with subgaleal haemorrhage from a cohort of 23,353 live and term deliveries, giving an incidence of subgaleal haemorrhage of 3.0 per 1000 live and term births. Multivariate analysis of risk factors associated with subgaleal haemorrhage on univariate analysis showed that prolonged second stage of labour (OR = 9.02; 95% CI 6.15-17.51), fetal distress (OR = 5.05; 95% CI 2.67-11.12), vacuum delivery (OR = 7.17; 95% CI 5.43-10.25), forceps delivery (OR = 2.66; 95% CI 1.78-5.18), and birthweight (OR = 2.20; 95% CI 1.54-6.56) significantly influenced the occurrence of subgaleal haemorrhage. When the effects of prolonged second stage of labour, fetal distress, birthweight and gestational age were controlled for, the odds of harbouring subgaleal bleed following vacuum delivery were, respectively, OR = 7.80 (95% CI 5.45-11.61), OR = 6.15 (95% CI 3.71-10.84), OR = 5.01 (95% CI 2.78-9.63) and OR = 7.65 (95% CI 4.73-16.65). Among the 69 newborns with subgaleal haemorrhage, ten (14%) died and twelve (20%) of the 59 survivors were lost to follow-up. Of the remaining 47 survivors, three (6%) died during follow-up of diseases unrelated to the bleed, leaving 44 survivors, none of whom had either neurological deficit or developmental delay. The study concludes that subgaleal haemorrhage in neonates is the result of birth trauma associated with difficult instrumental delivery. Newborns with subgaleal haemorrhage who survive the acute episode of the bleed show no evidence of subsequent long-term neurological deficit or developmental delay.

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“…Malgré la publication des premiers cas, il y a plusieurs décennies [2,5], son diagnostic n'est pas habituellement envisagé en phase initiale, car c'est une affection rare dont l'incidence varie, selon les séries, entre 0,2 à 1,6 pour 1 000 naissances [2,6,8]. Sa méconnaissance peut être source de retard thérapeutique et de morbidité ou de mortalité accrue.…”

Section: Discussionunclassified

A « caput succedaneum » and a pallor following birth asphyxia in the term newborn...

et al. 2009

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Massive Subaponeurotic Haemorrhage in Infants Born by Vacuum Extraction

Cited by 55 publications

References 10 publications

Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Subgaleal haemorrhage: risk factors and neurological and developmental outcome in survivors

A « caput succedaneum » and a pallor following birth asphyxia in the term newborn...

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