{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:38:25Z","timestamp":1791596305169,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,11]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Subgaleal hemorrhage (SGH<\/jats:styled-content>) is a life\u2010threatening neonatal condition that is strongly associated with vacuum assisted delivery (VAD<\/jats:styled-content>). The factors associated with the development of SGH<\/jats:styled-content> following VAD<\/jats:styled-content> are not well\u2010established. We aimed to evaluate the factors associated with the development of SGH<\/jats:styled-content> following attempted VAD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Material and methods<\/jats:title>A retrospective case\u2010control study of women who delivered at a tertiary university\u2010affiliated medical center in Jerusalem, Israel, during 2009\u20102018. Cases comprised all parturients with singleton pregnancies for whom attempted VAD<\/jats:styled-content> resulted in neonatal SGH<\/jats:styled-content>. A control group of VAD<\/jats:styled-content> attempts was established by matching one\u2010to\u2010one according to gestational age at delivery, parity and year of delivery. Fetal, intrapartum and vacuum procedure characteristics were compared between the groups.<\/jats:p><\/jats:sec>Results<\/jats:title>In all, 313 (89.5%) of the 350 attempted VAD<\/jats:styled-content> were nulliparous. Baseline maternal and fetal characteristics were similar between the groups except for higher neonatal birthweight in the SGH<\/jats:styled-content> group. In multivariate logistic regression analysis, only six independent risk factors were significantly associated with the development of SGH<\/jats:styled-content>: second\u2010stage duration (for each 30\u2010minute increase, adjusted odds ratio [OR<\/jats:styled-content>] 1.13; 95% confidence intervals [CI<\/jats:styled-content>] 1.04\u20101.25; P<\/jats:italic>\u00a0= .006), presence of meconium\u2010stained amniotic fluid (adjusted OR<\/jats:styled-content> 2.61; 95% CI<\/jats:styled-content> 1.52\u20104.48; P<\/jats:italic>\u00a0= .001), presence of caput succedaneum (adjusted OR<\/jats:styled-content> 1.79; 95% CI<\/jats:styled-content> 1.11\u20102.88; P<\/jats:italic>\u00a0= .01), duration of VAD<\/jats:styled-content> (for each 3\u2010minute increase, adjusted OR<\/jats:styled-content> 2.04; 95% CI<\/jats:styled-content> 1.72, 2.38; P<\/jats:italic> < .001), number of dislodgments (adjusted OR<\/jats:styled-content> 2.38; 95% CI<\/jats:styled-content> 1.66\u20103.44; P<\/jats:italic> < .001), and fetal head station (adjusted OR<\/jats:styled-content> 3.57; 95% CI<\/jats:styled-content> 1.42\u20108.33; P<\/jats:italic>\u00a0= .006). Receiver operating characteristic curves showed that VAD<\/jats:styled-content> duration of \u226515\u00a0minutes had a 96.7% sensitivity and 75.0% specificity in predicting SGH<\/jats:styled-content> formation, with an area under the curve equal to .849.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Vacuum duration, the number of dislodgments, the duration of second stage of delivery, fetal head station, the presence of caput succedaneum and the presence of meconium were found to be independently associated with SGH<\/jats:styled-content> formation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13678","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T21:00:45Z","timestamp":1561064445000},"page":"1464-1472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Risk factors associated with subgaleal hemorrhage in neonates exposed to vacuum 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Hadassah\u2010Hebrew University Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yossef","family":"Ezra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hadassah\u2010Hebrew University Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishay","family":"Sompolinsky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hadassah\u2010Hebrew University Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mankuta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hadassah\u2010Hebrew University Medical Center Jerusalem 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