title: Subgaleal hemorrhage with dural tear and parietal-lobe herniation in association with a vacuum extraction.
abstract: Use of the vacuum for operative vaginal deliveries has become more favorable with fewer obstetricians and family practitioners trained in the use of forceps. When compared with forcep-assisted deliveries, the vacuum has been associated with a higher incidence of subgaleal hemorrhage (SGH), cephalhematomas, skull and clavicular fractures, Erb's Palsy, intracranial hemorrhage and need for ICN admission. We report the case of an infant who developed a large SGH with midline dural tear and herniation of the medial aspect of the parietal lobes bilaterally in association with a vacuum extraction (VE) delivery. Counseling of families prior to instrumented delivery as to the potential complications, adherence to recommendations for abandoning operative vaginal delivery in favor of a cesarean section and close observation of those infants delivered by VE is warranted.
authors.affiliation: Wake Medical Center, Raleigh, NC 27610-1255, USA. skicklighter@wakemed.org
authors.forename: S D
authors.initials: SD
authors.lastname: Kicklighter
authors.forename: D
authors.initials: D
authors.lastname: Wolfe
authors.forename: J V
authors.initials: JV
authors.lastname: Perciaccante
mesh_terms: D001720:Birth Injuries / Q000209:etiology*; D020202:Cerebral Hemorrhage, Traumatic / Q000209:etiology*; D004388:Dura Mater / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010296:Parietal Lobe / Q000473:pathology; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects*