부산대학교 도서관

ObjectivesSubdural haematoma (SDH) is a recognised complication of forceps-assisted delivery (FAD). There are no guidelines regarding its management. This study aims to provide a better insight into the management and outcomes of neonatal SDH post FAD.DesignRetrospective review of our neonatal database and systematic review of the literature.SubjectsNeonatal cases presented with SDH after FAD.MethodsRetrospective database search of cases managed in our unit between January 20 111 and January 2018. Systematic review of the literature was performed using PRISMA guidelines. Inclusion criteria: (i) neonates, (ii) forceps-assisted delivery, (iii) evidence of SDH on imaging, with or without other traumatic lesions.ResultsA literature search yielded 9 studies with 30 patients meeting our inclusion criteria, In addition three cases were identified from our institutional database. 42% (n=14) had their SDH managed surgically, with subsequent full neurological recovery in 57%. In comparison, 95% (n=18) of the conservatively managed patients made a full recovery. Hydrocephalus was present in 1 and 11 of the conservatively managed and surgically managed patients, respectively.ConclusionsConservative management can lead to a full neurological recovery in SDH following FAD in neonates. However, a significant number may still need neurosurgical intervention for the SDH or subsequent hydrocephalus, therefore we advocate early transfer to a specialist neuroscience centre.