Vacuum extraction, bone injury and neonatal subgaleal bleeding
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Abstract
In a population of 27 flemish newborns with subgaleal bleeding encountered within a period of 6 years, we studied the obstetrical, clinical and radiological data. In contrast with controversial findings from the available literature, there is little doubt that difficult, often elective vacuum extraction is the main cause of this neonatal emergency. Disturbances in haemostasis, when documented, were attributed to focal intrahaematoma consumption, except for one boy who presented with haemophilia and neonatal subgaleal bleeding. Conventional X-ray examination continues to be of importance for the documentation of suture diastasis, fissures and fractures. CT scan reveals both the amount of extra-osseous bleeding, the degree of bone displacement and injury as well as the type and extent of associated intracranial damage. Subgaleal haemorrhage rarely hides a growing synchrondrosal rupture.
Key words
Vacuum extraction Subgaleal bleeding Newborn CT scanPreview
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References
- 1.Aballi AJ, Lopez Banus V, Lamerens S de, Rozengvaig S (1959) Coagulation studies in the newborn period. III. Hemorrhagic disease of the newborn. Am J Dis Child 97:524–548Google Scholar
- 2.Aguero O, Alvarez H (1962) Fetal injury due to the vacuum extractor. Obstet Gynecol 19:212–217PubMedGoogle Scholar
- 3.Ahuja GL, Willoughby MLN, Kerr MM, Hutchison JH (1969) Massive subaponeurotic haemorrhage in infants born by vacuum extraction. BMJ 3:743–745PubMedGoogle Scholar
- 4.Awon MP (1964) The vacuum extractor — experimental demonstration of distortion of the fetal skull. J Obstet Gynaecol Br Cwlth 74:534–636Google Scholar
- 5.Bachmann KD, Friedmann G, Weiden H, Springman L, Schmidt E, Bolte A (1968) Pathologische Befunde bei Neugeborenen nach Entbindung durch Vakuumextraktion. Geburtshilfe Frauenheilkd 28:1090–1103Google Scholar
- 6.Bernard R, Sansor M, Rapezzi (1960) Anémie par hématome extensif du cuir chevelu chez le nouveau-né. Pédiatrie 15:588–592Google Scholar
- 7.Bird GL (1982) The use of the vacuum extractor. Clin Obstet Gynecol 9:641–661Google Scholar
- 8.Boon WH (1961) Vacuum extraction in obstetrics. Lancet II:662CrossRefGoogle Scholar
- 9.Bret AJ, Coiffora P (1961) Les ancêtres des ventouses obstétricales. Rev Fr Gynécol Obstét 7–8:535–553Google Scholar
- 10.Chalmers JA (1971) The ventouse. The obstretric vacuum extractor, Lloyd-Luke Ltd. London, pp 63–88Google Scholar
- 11.Cohen DL (1978) Neonatal subgaleal haemorrhage in haemophilia. J Pediatr 93:1022–1023PubMedGoogle Scholar
- 12.Fenichel GM, Webster DL, Wong WKT (1984) Intracranial haemorrhage in the term newborn. Arch Neurol 41:30–34PubMedGoogle Scholar
- 13.Fulst W (1960) Über Einwirkungen des Vakuumextraktor am kindlichen Schädel und Gehirn. Zentralbl Gynäkol 9:321–327Google Scholar
- 14.Hassim AM, Lucas C (1966) The place of the “ventouse” in developing Africa. J Obstet Gynaecol Br Cwlth 73:787–790Google Scholar
- 15.Hickl E-J, Grässel G, Kugler J, Fröschl J, Fendel H (1969) Neurologische, opthalmologische und radiologische Untersuchungen bei Neugeborenen nach Vakuumextraktion. Arch Gynäkol 207:41–42CrossRefGoogle Scholar
- 16.Issel EP von, Neumärker K-J, Neumärker M, Loetzke H-H, Kunz G, Wilcke G (1977) Zur Bedeutung von Phantomversuchen für die Pathogenese des mechanischen Geburtstrauma. Zentralbl Gynäkol 99:9–16Google Scholar
- 17.Kagwa-Nyanzi JA, Alpidousky VK (1972) Subaponeurotic haemorrhage in newborn infants. Clin Pediatr 11:224–227Google Scholar
- 18.Kozinn PJ, Ritz ND, Moss AH, Kaufman A (1964) Massive haemorrhage scalps of newborn infants. Am J Dis Child 108:413–417PubMedGoogle Scholar
- 19.Kozinn PJ, Rits ND, Horowitz AW (1965) Scalp haemorrhage as an emergency in the newborn. JAMA 194:567–568CrossRefPubMedGoogle Scholar
- 20.Lacomme M, Lewin D, Thierry E, Jamain B, Bret J (1965) Forceps, spatules et ventouses. Rev Fr Gynécol Obstétr 5:325–348Google Scholar
- 21.Lauridsen L, Pless J, Uhrenholdt A (1962) Vacuum-extraction. A follow-up study. J Obstet Gynaecol Br Cwlth 69:1019–1021Google Scholar
- 22.Lehman O, Andersson H, Hannsson G, Malmström T, Ryba W (1963) Postnatal subgaleal haematomas. Acta Obstet Gynecol Scand 42:358–366Google Scholar
- 23.Leonard S, Anthony B (1961) Giant cephalohematoma of newborn. Am J Dis Child 101:170–173PubMedGoogle Scholar
- 24.Malmström T, Jansson I (1964) Use of the vacuum extractor. Acta Obstetr Gynecol Scand 43:893–913Google Scholar
- 25.Pape KE, Wigglesworth JS (1979) Birth trauma. Haemorrhage, ischaemia and the perinatal brain. Spastics International Medical Publications, London, pp 61–84Google Scholar
- 26.Plauché WC (1980) Subgaleal hematoma. A complication of instrumenta delivery. JAMA 244:1597–1598CrossRefPubMedGoogle Scholar
- 27.Robinson RJ, Rossiter MA (1968) Massive subaponeurotic haemorrhage in babies of African origin. Arch Dis Child 43:684–687PubMedGoogle Scholar
- 28.Rohyans JA, Miser AW, Miser JS (1982) Subgaleal hemorrhage in infants with hemophilia: report of two cases and review of the literature. Pediatrics 70:306–307PubMedGoogle Scholar
- 29.Sjostedt JE (1967) The vacuum extractor and forceps in obstetrics. A clinical study. Kirjapaino Oy Ticto Helsinki 1967. Acta Obstet Gynecol Scand, vol XVI, [Suppl] 10:1–208Google Scholar
- 30.Van Der Horst RL (1963) Exsanguinating cephalhaematomata in African newborn infants. Arch Dis Child 38:280–285PubMedGoogle Scholar
- 31.Venezia R, Jahier C (1959) Sur une forme clinique particulière de la maladie hémorrhagique du nouveau-né: l'hématome souscutané crânien extensif. Pédiatrie 14:772–774Google Scholar