Vacuum delivery: 2 cases of subgaleal haemorrhage

Subgaleal haemorrhage (SGH) is a rare complication of vacuum delivery. Although SGH can rapidly be life-threatening, its symptoms are initially confused with both common
and benign cephalohematoma or caput succedaneum. Cardiovascular compromise lead to systemic difference in presentation: alterations in colour, heart rate and general
condition. Vital parameters are important clues to improve diagnosis after instrumental delivery.
The diagnosis of SGH remains clinical: important swelling of the scalp that accumulates in the declive areas, pallor, tachycardia, irritability, convulsions or hypotonia are
the main signs. No further investigation is necessary before urgent therapy. Management consists of rapid correction of hypovolemia with saline and/or red blood cell
transfusions.
Early initiation of treatment is associated with better outcomes but further follow-up studies are needed to better describe the uncertain prognosis.
We report two cases of subgaleal haemorrhages following vacuum-assisted deliveries. In both cases, the initial presentation was severe, with hypovolemic shock and
coagulopathy. Early diagnosis and intensive treatment resulted in a favourable outcome.