Neonatal subgaleal hemorrhage: twenty years of trends in incidence, associations, and outcomes.
Journal
Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
02
08
2022
accepted:
12
10
2022
revised:
05
10
2022
medline:
12
5
2023
pubmed:
29
10
2022
entrez:
28
10
2022
Statut:
ppublish
Résumé
In 2011, we reported 38 neonates with subgaleal hemorrhage (SH), relating an increasing incidence. It is unclear whether the incidence in our hospitals continued to rise and which risk factors and outcomes are associated with this condition. We retrospectively analyzed every recognized case of SH in our hospitals from the end of our previous report (2010) to the present (2022). We redescribed the incidence, scored severity, tabulated blood products transfused, and recorded outcomes. Across 141 months, 191 neonates were diagnosed with SH; 30 after vacuum or forceps. The incidence (one/1815 births) was higher than in our 2011 report (one/7124 births). Also, severe SH (requiring transfusion) was more common (one/10,033 births vs. one/20,950 births previously). Four died (all with severe SH) and 12 had neurodevelopmental impairment. Recognized cases of SH are increasing in our system without a clear explanation. Adverse outcomes are rare but continue to occur.
Sections du résumé
BACKGROUND
In 2011, we reported 38 neonates with subgaleal hemorrhage (SH), relating an increasing incidence. It is unclear whether the incidence in our hospitals continued to rise and which risk factors and outcomes are associated with this condition.
DESIGN
We retrospectively analyzed every recognized case of SH in our hospitals from the end of our previous report (2010) to the present (2022). We redescribed the incidence, scored severity, tabulated blood products transfused, and recorded outcomes.
RESULTS
Across 141 months, 191 neonates were diagnosed with SH; 30 after vacuum or forceps. The incidence (one/1815 births) was higher than in our 2011 report (one/7124 births). Also, severe SH (requiring transfusion) was more common (one/10,033 births vs. one/20,950 births previously). Four died (all with severe SH) and 12 had neurodevelopmental impairment.
CONCLUSION
Recognized cases of SH are increasing in our system without a clear explanation. Adverse outcomes are rare but continue to occur.
Identifiants
pubmed: 36307481
doi: 10.1038/s41372-022-01541-z
pii: 10.1038/s41372-022-01541-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
573-577Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.
Références
Chadwick LM, Pemberton PJ, Kurinczuk JJ. Neonatal subgaleal haematoma: associated risk factors, complications and outcome. J Paediatr Child Health. 1996;32:228–32.
doi: 10.1111/j.1440-1754.1996.tb01559.x
pubmed: 8827540
Levin G, Mankuta D, Eventov-Friedman S, Ezra Y, Koren A, Yagel S, et al. Factors associated with the severity of neonatal subgaleal haemorrhage following vacuum assisted delivery. Eur J Obstet Gynecol Reprod Biol. 2020;245:205–9.
doi: 10.1016/j.ejogrb.2019.12.012
pubmed: 31902544
Levin G, Elchalal U, Yagel S, Eventov-Friedman S, Ezra Y, Sompolinsky Y, et al. Risk factors associated with subgaleal hemorrhage in neonates exposed to vacuum extraction. Acta Obstet Gynecol Scand. 2019;98:1464–72.
doi: 10.1111/aogs.13678
pubmed: 31220332
Boo NY, Foong KW, Mahdy ZA, Yong SC, Jaafar R. Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction. BJOG 2005;112:1516–21.
doi: 10.1111/j.1471-0528.2005.00732.x
pubmed: 16225572
Lee SJ, Kim JK, Kim SJ. The clinical characteristics and prognosis of subgaleal hemorrhage in newborn. Korean J Pediatr. 2018;61:387–91.
doi: 10.3345/kjp.2018.06800
pubmed: 30304906
pmcid: 6313086
Kilani RA, Wetmore J. Neonatal subgaleal hematoma: presentation and outcome—radiological findings and factors associated with mortality. Am J Perinatol. 2006;23:41–8.
doi: 10.1055/s-2005-923438
pubmed: 16450272
Uchil D, Arulkumaran S. Neonatal subgaleal hemorrhage and its relationship to delivery by vacuum extraction. Obstet Gynecol Surv. 2003;58:687–93.
doi: 10.1097/01.OGX.0000086420.13848.89
pubmed: 14515066
Swanson AE, Veldman A, Wallace EM, Malhotra A. Subgaleal hemorrhage: risk factors and outcomes. Acta Obstet Gynecol Scand 2012;91:260–3.
doi: 10.1111/j.1600-0412.2011.01300.x
pubmed: 21995823
Liu LY, Antaya RJ. Neonatal subgaleal hematoma from trauma during vaginal delivery without instrument use. Pediatr Dermatol 2017;34:e40–e41.
doi: 10.1111/pde.13037
pubmed: 27981624
El-Dib M, Parziale MP, Johnson L, Benson CB, Grant PE, Robinson J, et al. Encephalopathy in neonates with subgaleal hemorrhage is a key predictor of outcome. Pediatr Res. 2019;86:234–41.
doi: 10.1038/s41390-019-0400-1
pubmed: 30999320
Levin G, Mankuta D, Eventov-Friedman S, Ezra Y, Elchalal U, Yagel S, et al. Neonatal subgaleal hemorrhage unrelated to assisted vaginal delivery: clinical course and outcomes. Arch Gynecol Obstet. 2020;301:93–9.
doi: 10.1007/s00404-019-05392-6
pubmed: 31768745
Rohyans JA, Miser AW, Miser JS. Subgaleal hemorrhage in infants with hemophilia: report of two caes and review of the literature. Pediatrics 1982;70:306–7.
doi: 10.1542/peds.70.2.306
pubmed: 7099803
Wetzel EA, Kingma PS. Subgaleal hemorrhage in a neonate with factor X deficiency following a non-traumatic cesarean section. J Perinatol 2012;32:304–5.
doi: 10.1038/jp.2011.122
pubmed: 22460599
Christensen RD, Baer VL, Henry E. Neonatal subgaleal hemorrhage in a multihospital healthcare system: prevalence, associations, and outcomes. E J Neo Res. 2011;1:1–8.
Bahr TM, Kerry BB, Baserga MC, Christensen RD. Improving thermoregulation in transported preterm infants. J Perinatol. 2021;41:356–7.
doi: 10.1038/s41372-020-00812-x
pubmed: 32884103
Hulse W, Bahr TM, Fredrickson L, Canfield CM, Friddle K, Pysher TJ, et al. Warming blood products for transfusion to neonates: In vitro assessments. Transfusion 2020;60:1924–8.
pubmed: 32776545
Plauche. Subgaleal hematoma. A complication of instrumental delivery. JAMA 1980;244:1597–8.
doi: 10.1001/jama.1980.03310140055031
pubmed: 7420661
Hünseler C, Kribs A, Eifinger F, Roth B. Recombinant activated factor seven in acute life-threatening bleeding in neonates: report on three cases and review of literature. J Perinatol. 2006;26:706–13.
doi: 10.1038/sj.jp.7211588
pubmed: 17066067
Strauss T, Kenet G, Schushan-Eisen I, Mazkereth R, Kuint J. Rescue recombinant activated factor VII for neonatal subgaleal hemorrhage. Isr Med Assoc J. 2009;11:639–40.
pubmed: 20077956
Legge N, Guaran R. Critical bleeding protocol for infants used for a catastrophic subgaleal hemorrhage. J Paed Child Health. 2022;58:542–5.
doi: 10.1111/jpc.15591
Gertler R, Grubler M, Grassin-Delyle, Urien S, Martin K, Tassani-Prell P, et al. Pharmacokinetics of tranexamic acid in neonates and infants undergoing cardiac surgery. Br J Clin Pharm. 2017;83:1745–57.
doi: 10.1111/bcp.13274
Devereaux PJ, Marcucci M, Painter TW, Conen D, Lomivorotov V, Sessler DI, et al. Tranexamic acid in patients undergoing noncardiac surgery. N. Engl J Med. 2022;26:386 1986–97.
doi: 10.1056/NEJMoa2201171
Vanderspurt CK, Spinella PC, Cap AP, Hill R, Matthews SA, Corley JB, et al. The use of whole blood in US military operations in Iraq, Syria, and Afghanistan since the introduction of low-titer Type O whole blood: feasibility, acceptability, challenges. Transfusion 2019;59:965–70.
pubmed: 30548277
Bahr TM, DuPont TL, Morris DS, Pierson SE, Esplin MS, Brown SM, et al. First report of using low-titer cold-stored type O whole blood in massive postpartum hemorrhage. Transfusion 2019;59:3089–92.
doi: 10.1111/trf.15492
pubmed: 31469450
Carr NR, Henry E, Bahr TM, Ohls RK, Page JM, Ilstrup SJ, et al. Fetomaternal hemorrhage: Evidence from a multihospital healthcare system that up to 40% of severe cases are missed. Transfusion 2022;62:60–70.
doi: 10.1111/trf.16710
pubmed: 34674275
Carr NR, Hulse WL, Bahr TM, Davidson JM, Ilstrup SJ, Christensen RD First report of transfusing low-titer cold-stored type O whole blood to an extremely-low-birth-weight neonate after acute blood loss. Transfusion. 2022. https://doi.org/10.1111/trf.17034 .
Jacquot C, Mo YD, Luban NLC Transfusion Practices. In Neonatal Hematology, 3
Leeper CM, Yazer MH, Triulzi DJ, Neal MD, Gaines BA. Whole blood is superior to component transfusion for injured children: A propensity matched analysis. Ann Surg. 2020;272:590–4.
doi: 10.1097/SLA.0000000000004378
pubmed: 32932312
Leeper CM, Yazer MH, Cladis FP, Saladino R, Triulzi DJ, Gaines BA. Cold-stored whole blood platelet function is preserved in injured children with hemorrhagic shock. J Trauma Acute Care Surg. 2019;87:49–53.
doi: 10.1097/TA.0000000000002340
pubmed: 31033893
Leeper CM, Yazer MH, Morgan KM, Triulzi DJ, Gaines BA. Adverse events after low titer group O whole blood versus component product transfusion in pediatric trauma patients: A propensity-matched cohort study. Transfusion. 2021;61:2621–8.
doi: 10.1111/trf.16509
pubmed: 34047385
Morgan KM, Yazer MH, Triulzi DJ, Strotmeyer S, Gaines BA, Leeper CM. Safety profile of low-titer group O whole blood in pediatric patients with massive hemorrhage. Transfusion. 2021;61:S8–s14.
doi: 10.1111/trf.16456
pubmed: 34269441
Salazar EG, Handley SC, Greenberg LT, Edwards EM, Lorch SA Measuring quality of care in moderate and late preterm infants. J Perinatol. 2022. https://doi.org/10.1038/s41372-022-01 .
Bi SY, Yu YH, Li C, Xu P, Xu HY, Li JH, et al. A standardized implementation of multicenter quality improvement program of very low birth weight newborns could significantly reduce admission hypothermia and improve outcomes. BMC Pediatr. 2022;14:281. 22.
doi: 10.1186/s12887-022-03310-5
Hausfeld K, Baker RB, Boettcher-Prior P, Hancock D, Helms C, Jablonski T, et al. Randomized prospective clinical trial comparing room temperature and warmed intravenous fluid boluses on pediatric patients’ comfort. J Pediatr Nurs. 2015;30:e3–9.
doi: 10.1016/j.pedn.2015.07.006
pubmed: 26277355
Blumenberg A. Dosing heat: expected core temperature change with warmed or cooled intravenous fluids. Ther Hypothermia Temp Manag 2021;11:223–9.
doi: 10.1089/ther.2020.0036
pubmed: 33136530
Nair SS, Sreedevi V, Nagesh DS. Warming of blood and intravenous fluids using low-power infra-red light-emitting diodes. J Med Eng Technol. 2021;45:614–26.
doi: 10.1080/03091902.2021.1936675
pubmed: 34251967
Mattson MK, Groves C, Smith MM, Christensen JM, Chen D, Stubbs JR, et al. Platelet transfusion: The effects of a fluid warmer on platelet function. Transfusion 2021;61:52–6.
doi: 10.1111/trf.16139
pubmed: 33078463
Patel S, Ohls RK. Darbepoetin administration in term and preterm neonates. Clin Perinatol. 2015;42:557–66.
doi: 10.1016/j.clp.2015.04.016
pubmed: 26250917
pmcid: 4529960
Ohls RK, Kamath-Rayne BD, Christensen RD, Wiedmeier SE, Rosenberg A, Fuller JA, et al. Cognitive outcomes of preterm infants randomized to darbepoetin, erythropoietin or placebo. Pediatrics 2014;133:1023–30.
doi: 10.1542/peds.2013-4307
pubmed: 24819566
pmcid: 4531269
Ohls RK, Cannon DC, Phillips J, Caprihan A, Patel S, Winter S, et al. Preschool assessment of preterm infants treated with darbepoetin and erythropoietin. Pediatrics 2016;137:1–9.
doi: 10.1542/peds.2015-3859
Burd J, Gomez J, Berghella V, Bellussi F, de Vries B, Phipps H, et al. Prophylactic rotation for malposition in the second stage of labor: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol MFM 2022;4:100554 https://doi.org/10.1016/j.ajogmf.2021.100554 . Epub 2022 Feb 6.
doi: 10.1016/j.ajogmf.2021.100554
pubmed: 35139392