Subgaleal haemorrhage — RACP Paediatrics MCQ

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HardNeonatalSubgaleal haemorrhageRACP Paediatrics

A term neonate after vacuum extraction develops a progressively enlarging, fluctuant scalp swelling that crosses suture lines. The infant becomes pale with tachycardia and falling haemoglobin. What is the most likely diagnosis?

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Correct answer: E — Subgaleal haemorrhage

A progressively enlarging swelling crossing suture lines with signs of hypovolaemia (pallor, tachycardia, falling Hb) is a subgaleal (subaponeurotic) haemorrhage. This is a potentially life-threatening emergency as the subgaleal space can accumulate a large blood volume. It is most commonly associated with vacuum extraction. Urgent fluid resuscitation, blood transfusion, and close monitoring are required.

Reference: RCH Melbourne – 2023 – Birth Injuries CPG; RACP Paediatric Curriculum – Neonatology