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Risk factors associated with subaponeurotic haemorrhage in full‐term infants exposed to vacuum extraction

Objectives  To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction. Design  A prospective observational study. Setting  In the labour room, operation theatre, postnatal wards and neonatal intensive care unit (NICU) of...

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Published in:BJOG : an international journal of obstetrics and gynaecology 2005-11, Vol.112 (11), p.1516-1521
Main Authors: Boo, Nem‐Yun, Foong, Kin‐Wai, Mahdy, Zaleha Abdullah, Yong, Sin‐Chuen, Jaafar, Rohana
Format: Article
Language:English
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Summary:Objectives  To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction. Design  A prospective observational study. Setting  In the labour room, operation theatre, postnatal wards and neonatal intensive care unit (NICU) of a tertiary teaching hospital. Population  All infants born in the hospital with a history of exposure to vacuum extraction. Methods  A prospective observational study carried out over a 26‐month period. All eligible infants were examined at birth and during the first 24 hours of life. Main outcome measures  A diagnosis of SAH was based on detection of a tender fluctuant scalp swelling that crossed the skull suture lines of infants. Results  Of 10,066 infants born in the hospital during the study period, 338 (3.4%) had exposure to vacuum extraction. SAH was detected in 71 (21.0%) of them. Forward multivariate logistic regression analysis showed that five factors were significantly associated with development of SAH: maternal nulliparity (adjusted odds ratio [OR]: 4.0; 95% confidence intervals [CI]: 1.6, 10.0), failed vacuum extraction (adjusted OR: 16.4; 95% CI: 2.0, 135.6), Apgar score of less than 8 at 5 minutes of life (adjusted OR: 5.0; 95% CI: 1.7, 15.2), marks of vacuum cup over the sagittal suture (adjusted OR: 4.4; 95% CI: 1.9, 10.2) and marks of leading edge of vacuum cup at
ISSN:1470-0328
1471-0528
DOI:10.1111/j.1471-0528.2005.00732.x