Prevention of hyperbilirubinemia by needle aspiration of subaponeurotic hemorrhage

ABSTRACT

Needle aspiration of massive subaponeurotic hemorrhage was performed in two neonates. Both infant's serum bilirubin dropped following the procedure and remained within physiologic range. We believe this approach may be advised in high risk babies in an attempt to avoid exchange transfusion. Severe hemorrhage under epicranial aponeurosis and in the subcutaneous tissue of the scalp by spontaneous as well as vacuum extraction deliveries has been reported frequently. The result of such a hemorrhage is acute anemia and severe hyperbilirubinemia. To our knowledge, needle aspiration of such hemorrhages has not been attempted as a means to prevent hyperbilirubinemia in the neonate. We are presenting here two cases in which an extremely severe subaponeurotic hemorrhage was needle aspirated in an attempt to prevent dangerous hyperbilirubinemia