Neonatology: subgaleal haemorrhage: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatology: subgaleal haemorrhage

Sample item

After a vacuum-assisted delivery, a baby has a boggy swelling over the scalp that crosses sutures and extends to the neck, with pallor, tachycardia and falling haemoglobin. What is the best next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Volume resuscitation with blood and monitoring of coagulation

Subgaleal haemorrhage lies between the aponeurosis and periosteum, can hold a large blood volume and causes hypovolaemic shock, especially after vacuum delivery. Management is aggressive resuscitation and correction of coagulopathy.

Option by option

  • A. Volume resuscitation with blood and monitoring of coagulation (correct)

    Correct. Blood volume replacement is lifesaving.

  • B. Observation without any investigations

    Observation alone may allow fatal blood loss.

  • C. Reassurance

    Reassurance is unsafe in a baby with shock.

  • D. Needle aspiration of the swelling

    Aspiration risks infection and does not treat hypovolaemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Volume resuscitation with blood and monitoring of coagulation. Subgaleal haemorrhage lies between the aponeurosis and periosteum, can hold a large blood volume and causes hypovolaemic shock, especially after vacuum delivery.

Why is "Observation without any investigations" not the answer?

Observation alone may allow fatal blood loss.

Why is "Reassurance" not the answer?

Reassurance is unsafe in a baby with shock.

Why is "Needle aspiration of the swelling" not the answer?

Aspiration risks infection and does not treat hypovolaemia.

What concept does this question test?

It tests Neonatology: subgaleal haemorrhage in Pediatrics. Management is aggressive resuscitation and correction of coagulopathy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatology: subgaleal haemorrhage?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.