{
    "abstract": "Neonatal adrenal hemorrhage (NAH) is an almost infrequent phenomenon (0.2-0.55%). Mechanical compression and alterations of venous pressure during delivery are considered the most probable explanations. Approximately 10% of the cases might have bilateral involvement. Clinical symptoms include abdominal mass, poor feeding, vomiting, prolonged jaundice, and anemia. Subgaleal hemorrhage (SGH) is one of the most clinically remarkable and potentially hazardous postnatal cranial injuries.\nAn early-term Iranian male neonate who was born through spontaneous vaginal delivery and experienced shoulder dystocia was diagnosed with bilateral NAH leading to adrenal insufficiency requiring glucocorticoid and mineralocorticoid supplementation. The SGH and jaundice were other postnatal complications. Serial monthly abdominal and brain ultrasound revealed complete regression of lesions after 70\u2009days. However, after 16\u2009months, the neonate has been still treated with hydrocortisone and fludrocortisone for the adrenal insufficiency diagnosis. He has a lower limit weight for age; however, developmental milestones have been appropriate for age.\nAdrenal hemorrhage and SGH should be examined and looked for, particularly with proven evidence of difficult delivery and asphyxia in at-risk newborns. Clinical and ultrasound follow-up is mandatory for the assessment of hemorrhage resolution and conservative management. The early detection and treatment of adrenal insufficiency by laboratory examination is strongly recommended in bilateral cases. Furthermore, the early recognition of postnatal SGH to prevent clinical and neurological outcomes seems essential.",
    "authors": [
        {
            "affiliation": "Department of Emergency, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.\nDepartment of Newborn Nursery, Neonates, and Pediatrics, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.\nDepartment of Family Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.",
            "firstname": "Golnaz Ghazizadeh",
            "initials": "GG",
            "lastname": "Esslami"
        },
        {
            "affiliation": "Department of Family Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran. amoienafshar@gmail.com.\nPediatrics Department, school of medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran. amoienafshar@gmail.com.",
            "firstname": "Atousa",
            "initials": "A",
            "lastname": "Moienafshar"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2022. The Author(s).",
    "doi": "10.1186/s12887-022-03314-1\n10.1186/s13052-019-0651-9\n10.4103/0971-9261.59607\n10.1016/S1726-4901(08)70153-9\n10.3348/kjr.2011.12.1.52\n10.1177/000992280104001002\n10.1007/s002470050509\n10.3109/14767058.2014.976550\n10.1055/s-0040-1713407\n10.2147/IMCRJ.S294475\n10.1148/radiographics.19.4.g99jl13949\n10.1111/jpc.12698\n10.1001/jama.1980.03310140055031\n10.1007/s00404-019-05392-6\n10.1136/adc.34.174.178\n10.1136/adc.48.3.183\n10.1007/s40477-017-0248-3\n10.1590/0004-282x20170016\n10.3345/kjp.2018.06800\n10.1055/s-2005-923438",
    "journal": "BMC pediatrics",
    "keywords": [
        "Adrenal insufficiency",
        "Hormonal therapy",
        "Neonatal adrenal hemorrhage",
        "Subgaleal hemorrhage (SGH)",
        "Ultrasound monitoring",
        "Vaginal delivery"
    ],
    "methods": null,
    "publication_date": "2022-05-06",
    "pubmed_id": "35513814\n31068206\n20419026\n27123406\n18818143\n21228940\n11681820\n9880641\n25327176\n24982811\n10884839\n18663265\n32898884\n33790660\n22802844\n10464802\n25109786\n7420661\n31768745\n21534338\n13650674\n29479447\n4735041\n28900528\n28355327\n11387919\n30304906\n16450272",
    "results": null,
    "title": "Neonatal bilateral adrenal hemorrhage and adrenal insufficiency accompanied by Subgaleal hematoma: a case report with brief review of literature.",
    "xml": "<Element 'PubmedArticle' at 0x788502f929d0>"
}