What is Neonatal Subgaleal Hemorrhage?

Posted By Kinnard, Clayton & Beveridge || Jun 20, 2016

A neonatal subgaleal hemorrhage is a potentially lethal condition that can affect newborn infants. It is a type of extracranial hemorrhage, meaning that it takes place outside of the skull, and occurs when a vein is ruptured, causing it to bleed into the space between the scalp and the skull. Also known as the subgaleal space, this type of injury is one of the most serious brain bleeds because nearly half of an infant’s blood volume can bleed into that space.

What Causes A Subgaleal Hemorrhage?

Vacuum extractors, generally used in order to speed up a difficult delivery, have dangerous side effects when used improperly. An estimated 90 percent of all subgaleal hemorrhages are caused by the improper use of a vacuum extractor during the delivery. Misuses of the device that can cause subgaleal hemorrhages include:

  • Applying too much force
  • Attempting to pull too hard
  • Leaving the suction cup on the infant’s head for a long period of time
  • Improperly placing the suction cup on the infant’s head
  • An excessive number of attempts at using the vacuum extractor

While improper use of a vacuum extractor is by far the most common cause of a subgaleal hemorrhage, other traumatic events during labor and delivery, including the use of forceps when attempting to assist the birth, can cause this kind of bleed.

If an infant was delivered with the assistance of a vacuum extractor, their vital signs, red blood cell count, ability to form blood clots, and head size are required to be constantly monitored. If not diagnosed and treated immediately, infants can go into shock. As the bleed continues, the infant’s head will continue to swell that can shift whenever they move. The infant will likely have pale skin, a fast heart rate, have difficulty feeding, are lethargic, have periods where they cease breathing, and may suffer from seizures due to the blood loss.

Treating a subgaleal hemorrhage includes aggressive administration of blood products like frozen plasma and packed red blood cells to avoid low blood pressure-induced shock. Saline may also be administered in order to treat ongoing bleeding and coagulation problems, and surgery may be required to remove the excess blood in the infant’s subgaleal space.

If not properly managed, infants who sustain and survive subgaleal hemorrhages have an increased risk of:

  • Permanent brain damage
  • Cerebral palsy
  • Seizure disorders
  • Hydrocephalus
  • Developmental delays
  • Intellectual disabilities
  • Abnormally elevated bilirubin levels

While neonatal subgaleal hemorrhages are rare conditions, they are among the most serious an infant can deal with. According to the Canadian Medical Association Journal (CMAJ), approximately one in four infants who require neonatal intensive care for this condition die. The U.S. Food and Drug Administration (FDA) released a public health advisory regarding the risks associated with vacuum assisted delivery devices nearly 20 years ago. In it, the FDA states,

“While no instrumented delivery is risk free, we are concerned that some health care professionals who use vacuum assisted delivery devices, or those who care for these infants following delivery, may not be aware that the device may produce life-threatening complications.”

If your infant sustained a neonatal subgaleal hemorrhages, contact the Nashville birth injury attorneys at Kinnard, Clayton & Beveridge today. We have handled more medical malpractice cases than any other plaintiff’s firm in Tennessee, so you know that we have the experience and know-how necessary to get you the compensation you deserve. Call us at (615) 933-2893, or fill out the online form to get started with a free case evaluation.

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