Intracranial hemorrhage in infants after massaged by a traditional birth attendant

Elisabeth S. Herini; Sunartini Hapsara; S. Yudha Patria

doi:10.14238/pi47.3.2007.130-5

Elisabeth S. Herini
Sunartini Hapsara
S. Yudha Patria

DOI: https://doi.org/10.14238/pi47.3.2007.130-5

Keywords: Intracranial hemorrhage, infant, traditional massaged

Abstract

Background The overall incidence of birth related injuries declines
with the improvement in obstetrics. However, the incidence of
head trauma in infants after massaged by a traditional birth
attendant (TBA) is still unknown.
Objective To study the characteristics of intracranial hemorrhage
in infants after massaged by a TBA.
Methods A retrospective study was conducted in Sardjito Hospital,
Yogyakarta, Indonesia between October 2001 and May 2005.
Infants with intracranial hemorrhage after massaged by a TBA
were included. Data on patientsâ€™ demography, history of massaging
by TBA, clinical presentation, and injury characteristics such as
anemia, clotting time (CT), bleeding time (BT), prothrombin time
(PT) and activated partial thromboplastin time (APTT) were
noted. Computed cranial tomography (CT) scans were performed.
Results A total of seven infants were diagnosed with intracranial
hemorrhage after massaged by a TBA. There were four males
and three females (mean age 46 days; range 27-60 days). All
infants were referred to Sardjito Hospital, Yogyakarta, Indonesia
with bad condition and anemia; mean hemoglobin level was 5.5
g/dl (range 3.7-8.3 g/dl). All infants presented with seizures.
Coagulation screening showed normal results in five patients. The
remaining patients had a prolonged CT and PT. CT scan showed
subdural hemorrhage in four patients, intracerebral hemorrhage
in four, epidural hemorrhage in two, and subarachnoid hemorrhage
in one. Two patients had chronic hemorrhage, while the rest had
acute hemorrhage. Four of them underwent craniotomy, two
patients were under an observation only, and one patient was not
treated due to parental refusal. Six patients survived and the one
who refused to be treated died.
Conclusions The parents, midwives, and doctors have to be aware
of head massaging since it may harm infants.

Author Biographies

Elisabeth S. Herini

Department of Child Health, Medical School, Gadjah Mada University, Sardjito Hospital, Yogyakarta, Indonesia.

Sunartini Hapsara

Department of Child Health, Medical School, Gadjah Mada University, Sardjito Hospital, Yogyakarta, Indonesia.

S. Yudha Patria

Department of Child Health, Medical School, Gadjah Mada University, Sardjito Hospital, Yogyakarta, Indonesia.

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