Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Arch Gynecol Obstet. 2024 Aug;310(2):673-684. doi: 10.1007/s00404-024-07581-4. Epub 2024 Jun 13.
To determine the obstetric factors affecting the development of depressed skull fracture in neonates.
This was a retrospectively cohort study on neonates born between July 2016 and August 2021. Neonates diagnosed with depressed skull fractures within one week of birth through X-ray and/or brain ultrasonography were included, and their mothers' obstetric characteristics were reviewed.
There were 12 cases in 6791 live births. Five women were over 35 years old. All except two were nulliparous. Five cases were delivered from labor induction and others presented with spontaneous labor. Except for two cases, delivery occurred within an hour after full cervical dilatation. Two cases were assisted by vacuum. None displayed fetal distress signs such as low Apgar scores below 7, meconium staining, and umbilical cord pH under 7.2. All depressed fractures were found in the right parietal area. Three cases resulted in focal hyperechoic lesion in brain ultrasonography and two of them showed small hemorrhage-like lesion in magnetic resonance imaging. All depressed skull fractures improved within 6 months in followed X-rays or ultrasonography.
There was no definitely associated obstetric condition for depressed skull fracture of neonates although nulliparous women were majority of the affected cases.
探讨影响新生儿凹陷性颅骨骨折发生的产科因素。
本研究为回顾性队列研究,纳入 2016 年 7 月至 2021 年 8 月期间出生的新生儿,通过 X 线和(或)颅脑超声诊断出生后 1 周内发生的凹陷性颅骨骨折患儿,分析其母亲的产科特征。
6791 例活产儿中共有 12 例发生凹陷性颅骨骨折,母亲年龄>35 岁者 5 例,均为初产妇,经阴道分娩者 10 例,剖宫产者 2 例,除 2 例外余均在宫口开全后 1 h 内分娩,2 例使用了真空吸引器助产,均未见胎儿窘迫征象(如 Apgar 评分<7 分、羊水粪染、脐动脉血 pH 值<7.2),凹陷性骨折均位于右侧顶骨,3 例行颅脑超声检查发现局部高回声病灶,2 例行颅脑 MRI 检查发现小出血灶,所有患儿经随访 X 线或超声检查发现凹陷性颅骨骨折均在 6 个月内愈合。
虽然初产妇多见,但新生儿凹陷性颅骨骨折的产科因素并不明确。