Neonatal Subgaleal Hemorrhage
B IRTH I NJURIES S ERIES # 2 Neonatal Subgaleal Hemorrhage Julie Reid, RNC, MSN, NNP E onatal subgal E A L H E morrhag E I S A N that used vacuum extraction.4 A number of other researchers Ninfrequent but potentially fatal complication of reported similar results.5–7 Gebremariam, however, has doc- childbirth, especially if accompanied by coagulation disor- umented the incidence of subgaleal hemorrhage to be much ders. A subgaleal hemorrhage is higher: 3 per 1,000 live and an accumulation of blood within term births and 19.7 per 1,000 8 the loose connective tissue of the ABSTRACT vacuum extraction births. More subgaleal space, which is located Subgaleal hemorrhages, although infrequent in the past, remarkable than the actual inci- between the galea aponeurotica are becoming more common with the increased use dence is the six- to sevenfold and the periosteum (Figure 1). of vacuum extraction. Bleeding into the large subgaleal increase in incidence when Unlike a cephalohematoma, a space can quickly lead to hypovolemic shock, which can vacuum extraction is applied at subgaleal hemorrhage can be be fatal. Understanding of anatomy, pathophysiology, risk delivery. massive, leading to profound factors, differential diagnosis, and management will assist In a three-year study in Hong hypovolemic shock.1,2 Although in early recognition and care of the infant with a subgaleal Kong, an infant born with subgaleal hemorrhage has a low hemorrhage. vacuum-assisted extraction was incidence rate, it is strongly 60 times more likely to develop associated
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