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Published on: March 28, 2025
Development of children with symptomatic intracranial hemorrhage born after vacuum extraction
Marjolein J C Schot1, Feico J J Halbertsma, Titia Katgert
1Department of Pediatrics and Neonatal ICU, Máxima Medisch Centrum, Veldhoven, The Netherlands.
Vacuum extraction significantly reduces perinatal morbidity/mortality. Increased occurrence of intracranial hemorrhage has been associated with vacuum extraction and is multifactorial; a causative effect is not assumed. Long-term developmental outcome data in this specific subpopulation are lacking and may differ from non-vacuum extraction-associated intracranial hemorrhage. Long-term follow-up of children with symptomatic vacuum extraction-associated intracranial hemorrhage was retrospectively analyzed using Bayley Scales of Infant Development. Twenty-five newborns were identified with symptomatic intracranial hemorrhage after vacuum extraction. Motor development was severely impaired in 4 children (16%, Bayley Scale score <55), moderately impaired in 5 children (20%, Bayley Scale score 55-69) and mildly impaired in 2 children (8%, Bayley Scale score 70-84). Mental development was severely impaired in 2 children (8%), moderately impaired in 3 children (12%) and mildly impaired in 5 children (20%). Impaired outcome was associated with parenchymal injury and seems to be a higher reported outcome in non-vacuum extraction-associated intracranial hemorrhage. The high prevalence of impaired development in symptomatic vacuum extraction-associated intracranial hemorrhage necessitates long-term follow-up.
Vacuum extraction significantly reduces perinatal morbidity/mortality. Increased occurrence of intracranial hemorrhage has been associated with vacuum extraction and is multifactorial; a causative effect is not assumed. Long-term developmental outcome data in this specific subpopulation are lacking and may differ from non-vacuum extraction-associated intracranial hemorrhage. Long-term follow-up of children with symptomatic vacuum extraction-associated intracranial hemorrhage was retrospectively analyzed using Bayley Scales of Infant Development. Twenty-five newborns were identified with symptomatic intracranial hemorrhage after vacuum extraction. Motor development was severely impaired in 4 children (16%, Bayley Scale score <55), moderately impaired in 5 children (20%, Bayley Scale score 55-69) and mildly impaired in 2 children (8%, Bayley Scale score 70-84). Mental development was severely impaired in 2 children (8%), moderately impaired in 3 children (12%) and mildly impaired in 5 children (20%). Impaired outcome was associated with parenchymal injury and seems to be a higher reported outcome in non-vacuum extraction-associated intracranial hemorrhage. The high prevalence of impaired development in symptomatic vacuum extraction-associated intracranial hemorrhage necessitates long-term follow-up.
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