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Subgaleal Hematoma following Traumatic Birth Events

Published on: October 20, 2021

A subgaleal hematoma can be a life-threatening newborn complication following birth.

Giving birth is a common event, yet no two births are exactly alike.  While parents may plan on natural childbirth, others anticipate a scheduled C-section. Few expectant couples understand how quickly dreams of a happy childhood and grown children can dissipate if complications arise after a birth injury.

Each year, approximately six to nine of every 1,000 newborns experience some form of birth trauma.  Among other forms of birth injury, a subgaleal hematoma (SGH) occurs when the head of a baby meets with enough force that the veins which pass from the outside of the skull to inside of the skull are bruised, ruptured, or even severed during delivery. 

The result of the injury is an accumulation of blood in the subgaleal space, which is among the layers of tissue over the skull that is loose and fibrous and allows the scalp to move. While a subgaleal hematoma, or hemorrhage, can occur after a natural vaginal or C-section delivery, they are more commonly associated with delivery involving instruments.

Although many instruments are used during delivery, forceps and vacuum extraction figure prominently in statistics involving subgaleal hematoma. Forceps and vacuum extraction are used when a baby is in position to be delivered, but labor is not progressing.  This can often occur during a prolonged second stage of delivery.

Forceps and vacuum extraction are used to guide the head of a downward facing baby.  The use of instruments requires careful, smooth pulling and rotation of the baby.  Forceps used inappropriately can cause significant head trauma include skull fracture, brain injury, and seizures. 

Vacuum extraction requires the placement of a soft cup directly on the fetal head.  Poor placement and use can cause pop-offs that require correction, multiple attempts, and potentially dangerous traction on the head and upper body of a baby.  The use of a vacuum can contribute to the shoulder of a baby getting stuck (shoulder dystocia), skull fracture, and bleeding within and outside the skull.

Failed vacuum extraction can contribute to fetal distress and potentially birth asphyxia, a condition where the baby does not receive enough oxygen.

After an instrument delivery, monitoring for a subgaleal hematoma by healthcare providers is critical. If a SGH is unnoticed, a newborn may lose 20 to 40 percent of their blood volume, causing acute shock, brain injury, multi-organ failure, and even death.  Quick and effective treatment of a subgaleal hematoma can reduce or eliminate risk of permanent birth injury. Symptoms of a SGH include swelling of the head, pallor, abnormal heartbeat and blood pressure, and labored breathing.

While some birth injuries are natural complications, others are not.  If your child suffers serious injury as a result of a traumatic birth, speak with our legal team for answers to your questions.

Experienced medical malpractice lawyers fight for compensation on your behalf in Baltimore and Washington, DC

Schochor, Staton, Goldberg, and Cardea, P.A. serves patients and their families across the US.  When your healthcare provider makes a mistake, we fight for the compensation you need to move forward after serious injury. Call 410-234-1000 or contact us today to schedule a free consultation.

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