|According to a report in The Irish Times on 24th August 2023, Galway University Hospital commissioned a review of head injuries to newborn babies during delivery. The review is into what it terms a “small number of cases where newborn babies suffered head injuries as they were being delivered last year.”
The decision to review these cases suggests that there is an abnormally high number of babies being born in Galway University Hospital with these head injuries. Time will tell whether or not there is any human cause for the injury occurring more often than would be expected, and whether or not actions are necessary to bring that number down.
What is a subgaleal haematoma or subgaleal haemorrhage?
Subgaleal hematomas and haemorrhage, though relatively rare, are medical conditions that can have serious consequences if not promptly diagnosed and treated. It involves the accumulation of blood in the subgaleal space, which is the potential space between the galea aponeurotica (the tough, fibrous tissue covering the skull) and the periosteum (the membrane covering the bones of the skull).
Subgaleal hematomas often result from trauma to the head can occur during difficult or traumatic births involving prolonged labour, large babies or improper use of delivery tools (both vacuum-assisted deliveries, and those involving the use of forceps.) Recognising the symptoms of subgaleal hematomas is essential for early intervention. In infants, signs may include a soft, puffy, or swollen area on the baby’s head, irritability, pallor, or a noticeable increase in head circumference.
Diagnosis and Treatment of Subgaleal Hematomas
Diagnosing subgaleal hematomas typically involves a physical examination and imaging studies, such as ultrasound or CT scans. The condition can sometimes be mistaken for caput succedaneum, a benign swelling of the baby’s soft tissues. Treatment depends on the size and severity of the hematoma. Small hematomas may resolve on their own, but larger ones may require surgical intervention to remove the accumulated blood and prevent complications like anaemia or increased intracranial pressure.
Are subgaleal haematomas or haemorrhage serious?
If left untreated, subgaleal hematomas can lead to serious complications. In infants, excessive bleeding can result in anaemia and may necessitate blood transfusions. There can also be a risk of increased intracranial pressure due to the expanding hematoma, potentially causing neurological issues. However, with prompt diagnosis and appropriate treatment, the prognosis for subgaleal hematomas is generally favourable. According to the Irish Times report, the babies the subject of the review were all discharged in a healthy condition.
Naturally however, people may have concerns that these head injuries will continue to occur at Galway University Hospital and the consequences of a serious haematoma or haemorrhage being missed could be devastating.
Can subgaleal haematoma or haemorrhage be caused by negligence?
Improper use of delivery instruments, or a decision to delay Caesarean section inappropriately can lead to sustaining a subgaleal haematoma or haemorrhage.
If you have concerns about your child’s birth and its relationship to any traumatic injury, you can speak to Johan Verbruggen or one of our other medical negligence solicitors on 091-865000 or by email to firstname.lastname@example.org