Korean J Pediatr.  2018 Dec;61(12):387-391. 10.3345/kjp.2018.06800.

The clinical characteristics and prognosis of subgaleal hemorrhage in newborn

• Lee SJ
• Kim JK
• Kim SJ

• KMID: 2433727
• DOI: http://doi.org/10.3345/kjp.2018.06800

Abstract

PURPOSE
Subgaleal hemorrhage (SGH) is a rare but potentially fatal condition in newborns; however, few studies have reported on this condition. We aimed to identify the clinical characteristics and prognostic factors of SGH.
METHODS
We retrospectively reviewed the medical records of 20 neonates diagnosed with SGH between January 2000 and June 2017. Enrolled neonates were clinically diagnosed when they had tender fluctuant scalp swelling that crossed the suture lines.
RESULTS
Among 20 neonates with SGH, 12 were boys and 7 were girls; median hospitalization duration was 9.7±6.9 days. Fourteen neonates (70%) were born via vacuum-assisted vaginal delivery, and 4 via vacuum-assisted cesarean section. Of the neonates enrolled, half of them initially showed unstable vital signs, including apnea, desaturation, and cyanosis. Ten neonates had acidosis and 3 had asphyxia (pH < 7.0). Intracranial lesions associated with SGH were observed in 15 neonates (75%), including subdural hemorrhage (50%), subarachnoid hemorrhage (15%), intraventricular hemorrhage (5%), cerebral infarct (15%), skull fracture (30%), and cephalohematoma (20%). Twelve neonates (60%) required transfusion, 5 (25%) had seizures, and 3 (15%) died. Eight neonates (40%) had hyperbilirubinemia (mean total bilirubin, 13.1±7.4). The mean follow-up period was 8.4±7.5 months. At follow-up, 10 neonates (58.8%) were healthy with normal development, whereas 7 (41.2%) had neurological deficits.
CONCLUSION
The morbidity rate was 41.2% due to severe metabolic acidosis. Anemia, hyperbilirubinemia, low Apgar scores, and subdural hemorrhage did not affect the prognosis. The long-term outcomes of neonates with SGH are generally good. Only arterial blood pH was significantly associated with death.

Keyword

Subgaleal hemorrhage; Vacuum extraction delivery

MeSH Terms

Acidosis
Anemia
Apnea
Asphyxia
Bilirubin
Cesarean Section
Cyanosis
Female
Follow-Up Studies
Hematoma, Subdural
Hemorrhage*
Hospitalization
Humans
Hydrogen-Ion Concentration
Hyperbilirubinemia
Infant, Newborn*
Medical Records
Pregnancy
Prognosis*
Retrospective Studies
Scalp
Seizures
Skull Fractures
Subarachnoid Hemorrhage
Sutures
Vacuum Extraction, Obstetrical
Vital Signs
Bilirubin