Cephalohematoma on the head of a newborn: causes and consequences of injury

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

Cephalohematoma is an accumulation of blood between the flat bones of the skull and the connective bone film (periosteum). The disease belongs to common mechanical birth trauma (5 newborns out of 1000).

A cephalohematoma looks like a swelling, often with redness. The size of the tumor does not exceed the size of the bone over which they are located. Cephalohematoma holds from 5 to 150 ml of blood, in the first weeks it is liquid.

Main symptoms and diagnosis

It is impossible to detect such an injury immediately after the birth of a baby due to a birth tumor. If after 2-3 days there are swellings on the child's head, he is prescribed studies. There are cases when cephalohematoma in newborns manifests itself later.

During childbirth, the bones of the fetal head are squeezed and the periosteum is displaced. This sometimes leads to vascular damage in these areas. Due to the fact that the blood coagulation mechanism has not yet been formed in newborns, it accumulates between the periosteum and the bone and remains liquid.

A visual examination is performed to diagnose birth injuries. If the hematoma is small and does not continue to grow, no other diagnostic procedure is needed.

Additional research methods are used if:

• cephalohematoma more than 5 cm;
• the tumor continues to grow in size;
• the radius of propagation extends beyond the boundaries of the bone over which the injury is located.

A cephalohematoma in a newborn on the head, the consequences of which can be dangerous to his health, is recognized quite quickly.

If the baby has the above symptoms, additional research is carried out:

1. Study of the circulatory system for coagulability. A number of techniques are used to detect possible diseases.
2. Ultrasound. Allows you to clarify the foci of spread of hematoma, to detect hernias and bone damage.
3. X-ray. The study reveals the cracks and the nature of the fractures of the bones of the skull.

After a complete examination, the child is prescribed treatment.

Causes of cephalohematoma

Often, birth injuries are attributed to the negligent work of doctors. However, the methods of modern medicine can reduce the human factor to a minimum. Several decades ago, caesarean section was rarely used as an alternative to the usual labor process. Today, this method is used more often, which makes it possible to exclude birth injuries, even if the pregnancy was problematic.

A cephalohematoma appears on the head in newborns as a result of mechanical injuries that occur during hemorrhage. The reasons for the formation of a tumor are associated with both the fetus and the woman in labor, therefore they are divided into two types.

From the part of the woman in labor:

• Over 30 years old. During this period, a woman's body is considered less adapted to childbirth. The ovaries become less active. As a result, the elasticity of the uterus and vagina is lost.
• Diseases and injuries of the pelvic bones. If a woman in labor has diseases of the bones or organs of the pelvis, this can reduce the quality of labor and harm the fetus.
• Weak labor activity. Due to endocrine diseases or pathology of the uterine walls, the cycle of contractions gets confused or weakened, which can provoke birth trauma.
• Pelvic anomalies. This feature of the body is found in 7% of women. When combined with a baby's large head, a narrow or misshapen pelvis can cause birth injuries or abnormal fetal position.

Many mothers are interested in what types of cephalohematoma takes in newborns, what consequences may appear in the future and how to deal with them. With the right treatment, the baby will develop absolutely normally.

Reasons for the formation of a tumor on the part of the fetus:

1. Abnormal position. This phenomenon is observed even during pregnancy. In such cases, pregnancy proceeds under the strict supervision of a physician. Most often, with an abnormal position of the fetus, a cesarean section is performed.
2. Large fruit. After opening the cervix, the head of a large baby may not pass. This causes prolonged labor.
3. Diabetic fetopathy. A similar deviation occurs in the fetus if the mother has diabetes. Due to impaired glucose metabolism, the child is susceptible to various pathologies.

The discrepancy between the fetus and the pelvic ring is placed in a separate category. For successful childbirth, vacuum extraction is used, which leads to mechanical injuries. However, this method is considered deprecated and practically not used.

Effects

Possible complications of cephalohematoma on the head of a newborn can be diseases such as anemia (due to blood loss), jaundice, suppuration, deformation of the skull bones. Cephalohematoma on the head of a newborn, the consequences of which are quite serious, requires prompt diagnosis and proper treatment.

Types of cephalohematoma

Cephalohematomas vary in the size of the periosteal hemorrhage.

They are of 3 types:

• 1st degree - hemorrhage has a diameter of no more than 4 cm;
• 2nd degree - the diameter of the formation varies from 4, 1 to 8 cm;
• 3rd degree - the hematoma has a diameter of more than 8 cm.

At the 3rd degree, multiple formations usually take place. In this case, their total area is estimated. Hemorrhages can be localized in the temporal, parietal, occipital and frontal regions of the skull.

Treatment

With a small hemorrhage, the baby is provided with maximum rest. It is forbidden to rock the baby during this period. The doctor prescribes calcium gluconate (strengthens the vascular walls) and vitamin K (increases blood clotting). Regardless of the type to which a certain cephalohematoma in newborns belongs, treatment is carried out immediately after detection.

The types of medical intervention depend on the condition of the hematoma:

1. For large lesions, a puncture is performed. First, hair is removed at the site of the tumor and disinfection is carried out. The doctor makes a puncture of the wall of the hematoma with a special needle, through which its contents are removed.
2. If the integrity of the skin in the area of the hematoma is violated, suppuration may occur. In this case, the surgeon cuts the formation and removes its contents. Then anti-inflammatory treatment is prescribed. It includes dressing with antibacterial and disinfectant agents.
3. Ossified cephalohematoma in a newborn is an ossified tumor. It can only be removed surgically. The hematoma tissue is excised, after which sutures are applied to the area of operation. Until the child is fully recovered, a surgeon is watching him.

Calcium and vitamin K preparations are used for 3-5 days. Cephalohematoma in newborns, the consequences of which are quite serious, can recur. However, this can be prevented.

Prophylaxis

Periosteal hemorrhage can be avoided if the following conditions are met:

• the expectant mother should lead a healthy lifestyle, not take medications without consulting a doctor;
• the doctor and midwife must conduct the labor accurately, correctly and quickly choose the method of delivery.

For the prevention of repeated hemorrhage, the mother should not rock the child until 6 months. You can not refuse surgical treatment of hematoma. If your doctor recommends a caesarean section, it is best to choose this method of delivery. If these recommendations are followed, the child will quickly recover from the trauma.

A cephalohematoma noticed in time on the head of a newborn, the treatment of which is carried out quite easily, does not pose a danger to the child's life.

Outcomes

Calcified (ossified) cephalohematoma is very rare, but it must be treated immediately after detection. In the first week of life, the child is thoroughly examined. Correct treatment will not allow the tumor to negatively affect the development of the child.

Sometimes cephalohematoma is confused with a postpartum tumor. It is important to identify the formation in time and prescribe treatment. If you ignore the appearance of cephalohematoma, the child may remain disabled.

Knowledge of these features of the appearance and development of a rare birth trauma will help new mothers to cope with an unexpected "misfortune". The main thing is to follow all the doctor's recommendations and not self-medicate the child.