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帽状腱膜下血肿作为新生儿罕见血液系统问题的围产期表现。自身经验。

SUBGALEAL HEMATOMA AS A PERINATAL PRESENTATION OF RARE HEMATOLOGIC PROBLEMS IN NEWBORNS. OWN EXPERIENCE.

作者信息

Talar Tomasz, Pacześniak Urszula, Nowiczewski Marek, Kostrzewska Magdalena, Leszczyńska Katarzyna, Gulczyńska Ewa

出版信息

Dev Period Med. 2015 Jul-Sep;19(3 Pt 1):277-82.

Abstract

INTRODUCTION

Bleeding to the subgaleal space is a rare and often serious complication of childbirth. Delivery with the use of vacuum or forceps is considered as the main risk factor of subgaleal hemorrhage. Reports of other possible causes (including fetal ones) appear rarely.

OBJECTIVES

The aim of this study is to present and analyze two unusual cases of bleeding to subgaleal space in neonates delivered through caesarean section, in whom two different concomitant hematologic problems were diagnosed. The authors demonstrate also the mechanisms leading to the formation of subgaleal hematoma as well as discuss the impact of the final diagnosis on the course of the perinatal period and the need to modify medical practice in a variety of clinical situations in both newborns and their mothers.

MATERIAL AND METHODS

Authors present two consecutive cases of severe subgaleal hemorrhage.

RESULTS

In the first newborn hemophilia was finally diagnosed. The second neonate was diagnosed with neonatal alloimmune thrombocytopenia.

CONCLUSIONS

Subgaleal hemorrhage is a rare complication of delivery. In severe cases, other possible risks should be considered apart from the traumatic delivery only. An early identification of potential hematological risk factors can influence the effectiveness of the treatment and help to modify the follow-up of both the infant and its mother.

摘要

引言

帽状腱膜下间隙出血是一种罕见且往往较为严重的分娩并发症。使用真空吸引器或产钳分娩被认为是帽状腱膜下出血的主要危险因素。关于其他可能原因(包括胎儿因素)的报道很少见。

目的

本研究旨在呈现并分析两例通过剖宫产分娩的新生儿发生帽状腱膜下间隙出血的不寻常病例,这两例患儿被诊断出伴有两种不同的血液学问题。作者还阐述了导致帽状腱膜下血肿形成的机制,并讨论了最终诊断对围生期病程的影响,以及在新生儿及其母亲的各种临床情况下改变医疗实践的必要性。

材料与方法

作者呈现了两例连续的严重帽状腱膜下出血病例。

结果

第一例新生儿最终被诊断为血友病。第二例新生儿被诊断为新生儿同种免疫性血小板减少症。

结论

帽状腱膜下出血是一种罕见的分娩并发症。在严重病例中,除了创伤性分娩外还应考虑其他可能的风险。早期识别潜在的血液学危险因素可影响治疗效果,并有助于调整对婴儿及其母亲的随访。

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