What is Subgaleal Hemorrhage?
Subgaleal hemorrhage (SGH) is a condition characterized by bleeding into the subgaleal space, which lies between the galea aponeurotica and the periosteum of the skull. This condition is most commonly associated with neonates and can be a serious complication of childbirth.
Causes and Risk Factors
SGH is often caused by trauma to the head during delivery, which can result from the use of
vacuum extraction or
forceps. Other risk factors include prolonged or difficult labor, a large fetal head, and
coagulation disorders in the neonate.
Symptoms and Diagnosis
Early symptoms of SGH can include a boggy swelling of the scalp that crosses suture lines, pallor, tachycardia, and hypotension. The swelling is usually not confined to one area and can spread over the entire scalp. Diagnosis is primarily clinical, but
imaging studies like ultrasound or MRI can confirm the extent of the hemorrhage.
Complications
SGH can lead to significant complications, including
anemia,
hypovolemic shock, and even death if not promptly treated. The condition can also lead to increased intracranial pressure, which may result in long-term neurological damage.
Treatment
Treatment involves immediate supportive care, including fluid resuscitation and blood transfusions if necessary. Monitoring of the neonate's vital signs and hematocrit levels is critical. In severe cases, surgical intervention may be required to drain the hemorrhage and relieve pressure.
Prevention
Preventive measures include careful monitoring of labor and judicious use of assistive devices like vacuum extractors and forceps. Prenatal screening for coagulation disorders can also help identify at-risk infants. Proper training for healthcare providers in the management of difficult deliveries can reduce the incidence of SGH.
Prognosis
The prognosis for infants with SGH varies depending on the severity of the hemorrhage and the promptness of treatment. With timely and appropriate care, many infants recover completely. However, severe cases can result in long-term complications, including developmental delays and neurological deficits.
Conclusion
Subgaleal hemorrhage is a serious condition that requires immediate medical attention. Understanding the risk factors, early symptoms, and treatment options can help healthcare providers manage this condition effectively. Preventive strategies and prompt intervention are key to improving outcomes for affected infants.
