European Journal of Pediatrics

, Volume 151, Issue 7, pp 532–535 | Cite as

Vacuum extraction, bone injury and neonatal subgaleal bleeding

  • P. Govaert
  • P. Vanhaesebrouck
  • C. De Praeter
  • K. Moens
  • J. Leroy
Neonatology

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 scan 

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References

  1. 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. 2.
    Aguero O, Alvarez H (1962) Fetal injury due to the vacuum extractor. Obstet Gynecol 19:212–217PubMedGoogle Scholar
  3. 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. 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. 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. 6.
    Bernard R, Sansor M, Rapezzi (1960) Anémie par hématome extensif du cuir chevelu chez le nouveau-né. Pédiatrie 15:588–592Google Scholar
  7. 7.
    Bird GL (1982) The use of the vacuum extractor. Clin Obstet Gynecol 9:641–661Google Scholar
  8. 8.
    Boon WH (1961) Vacuum extraction in obstetrics. Lancet II:662CrossRefGoogle Scholar
  9. 9.
    Bret AJ, Coiffora P (1961) Les ancêtres des ventouses obstétricales. Rev Fr Gynécol Obstét 7–8:535–553Google Scholar
  10. 10.
    Chalmers JA (1971) The ventouse. The obstretric vacuum extractor, Lloyd-Luke Ltd. London, pp 63–88Google Scholar
  11. 11.
    Cohen DL (1978) Neonatal subgaleal haemorrhage in haemophilia. J Pediatr 93:1022–1023PubMedGoogle Scholar
  12. 12.
    Fenichel GM, Webster DL, Wong WKT (1984) Intracranial haemorrhage in the term newborn. Arch Neurol 41:30–34PubMedGoogle Scholar
  13. 13.
    Fulst W (1960) Über Einwirkungen des Vakuumextraktor am kindlichen Schädel und Gehirn. Zentralbl Gynäkol 9:321–327Google Scholar
  14. 14.
    Hassim AM, Lucas C (1966) The place of the “ventouse” in developing Africa. J Obstet Gynaecol Br Cwlth 73:787–790Google Scholar
  15. 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. 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. 17.
    Kagwa-Nyanzi JA, Alpidousky VK (1972) Subaponeurotic haemorrhage in newborn infants. Clin Pediatr 11:224–227Google Scholar
  18. 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. 19.
    Kozinn PJ, Rits ND, Horowitz AW (1965) Scalp haemorrhage as an emergency in the newborn. JAMA 194:567–568CrossRefPubMedGoogle Scholar
  20. 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. 21.
    Lauridsen L, Pless J, Uhrenholdt A (1962) Vacuum-extraction. A follow-up study. J Obstet Gynaecol Br Cwlth 69:1019–1021Google Scholar
  22. 22.
    Lehman O, Andersson H, Hannsson G, Malmström T, Ryba W (1963) Postnatal subgaleal haematomas. Acta Obstet Gynecol Scand 42:358–366Google Scholar
  23. 23.
    Leonard S, Anthony B (1961) Giant cephalohematoma of newborn. Am J Dis Child 101:170–173PubMedGoogle Scholar
  24. 24.
    Malmström T, Jansson I (1964) Use of the vacuum extractor. Acta Obstetr Gynecol Scand 43:893–913Google Scholar
  25. 25.
    Pape KE, Wigglesworth JS (1979) Birth trauma. Haemorrhage, ischaemia and the perinatal brain. Spastics International Medical Publications, London, pp 61–84Google Scholar
  26. 26.
    Plauché WC (1980) Subgaleal hematoma. A complication of instrumenta delivery. JAMA 244:1597–1598CrossRefPubMedGoogle Scholar
  27. 27.
    Robinson RJ, Rossiter MA (1968) Massive subaponeurotic haemorrhage in babies of African origin. Arch Dis Child 43:684–687PubMedGoogle Scholar
  28. 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. 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. 30.
    Van Der Horst RL (1963) Exsanguinating cephalhaematomata in African newborn infants. Arch Dis Child 38:280–285PubMedGoogle Scholar
  31. 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

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • P. Govaert
    • 1
  • P. Vanhaesebrouck
    • 1
  • C. De Praeter
    • 1
  • K. Moens
    • 1
  • J. Leroy
    • 1
  1. 1.Neonatal Intensive Care Unit, Department of Paediatrics, Gent University HospitalGentBelgium

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