239 Development of Children with Intracranial Hemorrhage Born After Vacuum Extraction

Abstract

Subject of the study: We describe the long term follow-up of a cohort of children with an intracranial hemorrhage (ICH) associated with vacuum extraction. Methods: We retrospectively searched our database from 1999 to 2007. Patient outcome was evaluated using the Bayley Scale of Infant Development (BSID-II-NL). Development was considered severely impaired if the scores were less than 55, moderately impaired if they were 55 to 69, and mildly impaired if they were 70 to 84. If a child did not complete the BSID-II-NL, a pediatrician estimated the child's developmental level. Results: We identified 25 patients with ICH after vacuum extraction. Eighteen patients were male. Mean gestational age was 39 weeks. Mean birth weight was 3283 grams. Clinical symptoms suspect for ICH varied among patients. Seizures were most frequently reported (60%). Subarachnoid hemorrhage was most frequently seen (n=12). Motor development was severely impaired in four children(16%), moderately impaired in one child (4%) and mildly impaired in six children (24%). Mental development was severely impaired in two children (8%), moderately impaired in one child (4%) and mildly impaired in seven children (28%). Conclusion: Delayed development is common in children with ICH after vacuum extraction. When there is a symptomatic ICH after vacuum extraction, long term follow-up is justified. Predictive factors for neurodevelopmental delay such as Apgarscores, gestational age or birth weight could not be deducted from our series.