In plain words
A subgaleal hemorrhage is bleeding into a loose space under the baby's scalp. The space sits above the skull and below the tough outer layer of the scalp, and it can hold a large amount of blood. It is most often linked to vacuum-assisted birth, when small veins in the scalp tear. The swelling is soft, shifts under the fingers, and can cross the seams of the skull. It may take hours to show. Parents may notice the baby looks pale or sleepy, or that the swelling keeps growing. Pediatric teams track blood counts and the size of the swelling. It is not the same as a , a shallow swelling that fades within days.
The deeper version
Bleeding into the potential space between the galea aponeurotica and the periosteum, a space continuous across the calvaria, so blood can track widely and hold a large share of neonatal blood volume. Rupture of emissary veins under traction is the proposed mechanism, and vacuum application is the strongest association. Presentation is a boggy, fluctuant swelling that crosses sutures, sometimes with pallor, tachycardia, and falling hematocrit. Serial and head measurements guide care. Differential diagnosis includes caput succedaneum and , which stays within one bone.
Where it comes up
- Vacuum and forceps birthsBirth and the First Days
- When the baby is injured at birthLoss and Complications
- The hospital stay: what happens, what to askBirth and the First Days
What mothers here say about subgaleal hemorrhage
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin 219: Operative Vaginal Birth, 2020
- Royal College of Obstetricians and Gynaecologists — Operative Vaginal Delivery, Green-top Guideline No. 26