Article Text

INTRACRANIAL HAEMORRHAGE FOLLOWING TERM DELIVERY
  1. T Benterud1,
  2. R Lindemann1
  1. 1NICU, Ullevål University Hospital, Oslo, Norway

Abstract

Introduction This study investigates the incidence of symptomatic intracranial haemorrhage (ICH) at Ullevål University Hospital between 2001 and 2006.

Methods Retrospective study. Haemorrhages were classified as epidural (EDH), subarachnoidal (SAH), subdural (SDH) or intracerebral. Mode of delivery, sex, head circumference, length, weight and Apgar score were registered as were method of diagnoses and need for treatment.

Results 40 424 children born between 2000 and 2006. 93% at term. 33 children with ICH. Two were diagnosed with magnetic resonance imaging and 31 with computed tomography. 17 patients had SDH, 11 intracerebral haemorrhage, two EDH, two had both SAH and SDH, only one had SAH only. 19 patients were born in gestational week 40/41. The incidence after vacuum delivery was higher than after vaginal delivery, p<0.001. More boys than girls, 26 : 7, p<0.001. The head circumference was significantly larger among the babies with ICH, 36 ± 0.6 cm, 95% CI. Differences in weight and length were not significant. Seven children had no associated trauma. Two had coagulopathies, one cavernous haemangiomas, two septicaemia and two asphyxia. 12% of the neonates had Apgar scores <5 at 5 minutes, versus 0.6% of the total number of babies. No patient needed surgical intervention. On follow-up, of the 33 patients with ICH, seven had neurological sequelae, possibly associated with haemorrhage. 23 patients had a normal psychomotoric development. Three patients had syndromes that coincidence with mental retadation.

Conclusion Symptomatic ICH occurs seldom (0.1%). Significantly higher incidence among boys, those delivered through vacuum and among children with a larger head circumference. The number of children with sequelae was very low, 0.02%.

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