Severe subgaleal hemorrhage following spontaneous vaginal delivery: Case report and literature review

Abstract

Neonatal SGH is an infrequent but underdiagnosed traumatic birth injury. When seen, it is often associated with vacuum-assisted delivery. Some cases, however, have been reported following spontaneous vaginal deliveries and non-traumatic cesarean delivery with no known associated risk factors. Diagnosis is often clinical and, depending on the time of detection, clinical signs can range from asymptomatic scalp swelling to life-threatening severe anemia, hyperbilirubinemia, acidosis, hypovolemic shock, and death. We present the case of a neonate with severe subgaleal hemorrhage following spontaneous vaginal delivery. The neonate had phototherapy, exchange blood transfusion, as well as top-up transfusions to correct hyperbilirubinemia and severe anemia. This case highlights the significance of early recognition and prompt intervention in the eventual outcome even in low-resource settings.