Linder N, Arad I
J Perinat Med. 1984;12(1):35-7.
In order to examine the pathogenesis of neonatal hyperbilirubinemia associated with vacuum extraction, we have compared plasma haptoglobin and bilirubin levels and blood hematocrits of vacuum extracted neonates with those of newborns who underwent a normal vaginal delivery. Plasma haptoglobin and blood hematocrits of the 12 vacuum patients measured on the third day of life were significantly lower (21.7 +/- 5.3 vs. 46.5 +/- 7.5 mg%; p value less than 0.01 and 52.3 +/- 1.3 vs. 59.7 +/- 1.8%; p value less than 0.005, respectively) than the 12 control patients (values are mean +/- SEM). This trend was apparent whether or not cephalhematoma was present after vacuum extraction: However, the mean bilirubin level was significantly higher than the controls only when cephalhematoma was present. Those results suggest that the higher incidence of neonatal hyperbilirubinemia previously observed after vacuum extraction, is the result of an increased hemolysis of blood sequestered in scalp lesions. Since evidence for enhanced RBC destruction has been demonstrated whether or not cephalhematoma was present, the possibility of hyperbilirubinemia should be anticipated in any case of vacuum delivery.
为了研究与真空吸引相关的新生儿高胆红素血症的发病机制，我们比较了真空吸引新生儿与正常阴道分娩新生儿的血浆触珠蛋白、胆红素水平及血细胞比容。12例接受真空吸引的患儿在出生后第3天测得的血浆触珠蛋白和血细胞比容显著低于12例对照患儿（分别为21.7±5.3 vs. 46.5±7.5mg%；p值小于0.01；52.3±1.3 vs. 59.7±1.8%；p值小于0.005）（数值为平均值±标准误）。无论真空吸引后是否存在头皮血肿，这种趋势都很明显：然而，仅当存在头皮血肿时，平均胆红素水平才显著高于对照组。这些结果表明，先前观察到的真空吸引后新生儿高胆红素血症发生率较高，是头皮损伤中血液溶血增加的结果。由于无论是否存在头皮血肿，均已证实存在红细胞破坏增强的证据，因此在任何真空分娩的情况下，都应预料到发生高胆红素血症的可能性。
