Subgaleal haematoma and subgaleal hemorrhages

Coleman Legal LLP have been consulted by a number of families affected where subgaleal haematomas have occurred during birth.

A subgaleal haematoma, also known as a subgaleal hemorrhage, is an accumulation of blood that forms between a newborn baby’s skull and the skin on their scalp. This can occur after a difficult delivery, particularly where the use of a vacuum extractor is required. The condition can be life-threatening. Emergency and immediate treatment leads to the best possible outcome. Subgaleal hemorrhages may cause the draining of a significant amount of blood from the newborn baby, putting them at risk of severe injuries such as seizures, neonatal encephalopathy (brain damage) or tragically, even death.

Causes of subgaleal haematoma

Subgaleal Haematomas/hemorrhages are caused by trauma to the head during labour and delivery.  Most commonly, this trauma is caused by the compressing of a baby’s head through the mother’s pelvis during delivery. The injury is most often occurs when vacuum extractors or forceps are used during delivery. Vacuum extractors can cause head trauma when the clinician places the suction cup on the incorrect section of the baby’s head, or applies too much force or pressure. It can also occur when the cup is suctioned for an excessive period of time, or  too many attempts  are made at using the vacuum extractor.

The majority (90%) of neonatal cases of subgaleal haematoma are the result of applying a vacuum to the head at delivery.

Risk factors for subgaleal haematoma

There are some factors that may make a neonate more susceptible to subgaleal hemorrhaging. These risks must be taken into consideration as clinicians make decisions regarding the birth of a child.

Some of the strongest risk factors for subgaleal haematoma in newborns are:

• Primiparity (first-time pregnancy)
• Male sex
• Prolonged second stage of labour
• Premature birth
• Cephalopelvic disproportion (where there is a mismatch between the size of a mother’s pelvis and the baby’s head)
• Macrosomia (when the baby is a larger size than average)

Diagnosis and treatment for subgaleal haematoma

Newborns who underwent difficult vacuum extraction or forceps delivery should be treated with a minimum of 8 hours of observation regardless of need for resuscitation. Their vital signs should also be assessed hourly. Head examinations should be done hourly if there is a concern about head swelling. These actions will assist with early diagnosis of hemorrhage. Newborn babies diagnosed with subgaleal haematoma must be treated immediately in order to prevent any further damage.

Long-term outcomes for children

Where subgaleal haematoma and subgaleal haemorrhages are not detected and treated promptly, there can be long-term negative outcomes, including

• Neonatal encephalopathy – A type of brain damage caused by a lack of oxygen to the brain before or shortly after birth
• Seizures
• Brain damage
• Hypoxic-ischemic encephalopathy (HIE) – A brain injury that happens when a baby’s brain doesn’t receive enough oxygen during delivery
• Periventricular leukomalacia – A type of brain injury that is most common in babies born prematurely or at a low birthweight. The white matter surrounding the ventricles of the brain is deprived of blood and oxygen.
• Cerebral palsy
• Developmental disabilities
• Kernicterus – A type of brain damage that can result from high levels of bilirubin in a baby’s blood. It may lead to athetoid cerebral palsy and also hearing loss. Kernicterus may also cause problems with teeth and vision. It may also cause intellectual disabilities.

Our team

Coleman Legal LLP

Solicitors
84 Talbot Street, Dublin 1
D01 YX60
DX 112002

Contact Details

Free Phone: (1800)844104
Fax: (01) 5312727
Email: [email protected]
Web: www.colemanlegalpartners.ie
Online Enquiry Form:Apply