Incidence and Risk Factors for Birth Injury to scalp in Buriram Hospital
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Abstract
Backgroud: Birth trauma is a complication of perinatal period. Birth injury to scalp is a serous condition for morbidities and mortalities.
Objective: To determine incidence and risk factors for birth injury to scalp (cephal hematoma and subgaleal hematoma) during perinatal period.
Setting: Buriram Provincial Hospital
Design: case-control study
Method: The data of pregnant women who were admitted to labor room at Buriram hospital during 1 October 2009-30 September 2010 was review. Inclusion criteria were case of term and singleton. Seventy cases of newborn were diagnosed cephal hematoma and subgaleal hematoma by obstetrician and pediatrician. Exclusion criteria were case of preterm labor, twins, still birth and severe anormalies. Control cases were case newborn who had no scalp injury, born follow the study case in ratio 1:2. Statistical analyses were performed using SPSS, Chisquare, Fisher Exact test and student t test. Stepwise multiple logistic regression analyze were performed to determine risk factors.
Result: All neonatal scalp injuries were cephal hematoma 42 cases and subgaleal hematoma 28 cases which due to vacuum delivery 45 cases (64.3%). Incidence rate was 10.7 /1000 livebirth. Risk factors which were significantly associated with birth injury to scalp were primigravidarum, vacuum delivery, BW>3500 gm. and delivery by Intern. Vacuum delivery is the leader of morbidities (anemia, hyperbilirubinemia and oxygen therapy) in newborns. Two neonates were death due to subgaleal hematoma with coagulopathy.
Conclusion: Most of risk factors of birth injury to scalp were difficult and traumatic delivery. Early detection of large baby, appropriated route of delivery and improved medical skill in obstetric/delivery practices should be decrease scalp injury in neonates.
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References
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