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Subgaleal hemorrhage from birth trauma: from the first stage of labor to the baby’s discharge: a clinical case at the intersection of specialties

DOI: https://doi.org/10.29296/25877305-2022-08-04
Issue: 
8
Year: 
2022

E. Shestak(1, 2), D. Svetlakova(1), K. Desyatnik(1)
1-Yekaterinburg Clinical Perinatal Center
2-Ural State Medical University, Ministry of Health of Russia, Yekaterinburg

Neonatal subgaleal hemorrhage (SH) is a common complication of vacuum extraction delivery. The baby’s condition after SH can progressively worsen up to death in 22% of cases. The basis for SH is a large blood accumulation volume in the subgaleal space, resulting in hemorrhagic shock and coagulopathy. The paper describes a clinical case of female patient M. who has undergone operative vaginal vacuum extraction done to deliver a baby, if clinically indicated. It analyzes the labor activity of Patient M., by providing a rationale for obstetric care tactics. The paper depicts the further worsening severity of neonatal infant’s condition in the presence of progressive bleeding into the subgaleal space, as well as neonatologists’ treatment policy, with a detailed description of instrumental and laboratory data up to the moment the patient’s discharge from hospital. An analysis of the clinical case showed that medical personnel alertness regarding the detection of SH after vacuum extraction delivery was a predetermining factor in the prognosis of the baby’s health and life. A particularly important step is to make a correct differential diagnosis of conditions similar to SH. Intensive infusion-transfusion therapy is in the first place while providing assistance and stabilizing the baby’s condition, since ongoing bleeding and hemorrhagic shock are the main causes of mortality in SH.

Keywords: 
obstetrics and gynecology
neonalogy
vacuum extraction
neonatal infant
subgaleal hematoma
birth trauma
coagulopathy



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