What Is a Cephalohematoma?
An accumulation of blood between a baby's scalp and skull is called a cephalohematoma. Blood is released from damaged blood vessels and collects under the scalp's skin as a mass. The blood vessels frequently sustain an injury while giving birth. It is brought on by pressure or damage to the head during labor or delivery. The baby's brain is not at risk of pressure or bleeding because it is beneath the skull bones, and the blood accumulation is on top of the skull. Therefore, there is no impact on the brain. After the birth, the cephalohematoma may take hours or even days to form because of the slow bleeding.
One of the most frequent birth injuries, cephalohematoma, affects one to two percent of all newborns during and after birth. While the majority of infant cephalohematoma normally goes away on their own without treatment, in some circumstances, the doctor may advise surgery to avoid complications.
What Are the Causes of Cephalohematoma?
Cephalohematomas in newborns typically develop during labor or delivery. After birth, it does not form for several hours or even days. The tiny blood arteries on the scalp may tear under extreme pressure or damage during delivery or labor, leading to a cephalohematoma.
Cephalohematomas can have a variety of origins, the most common of which is head trauma during delivery. One typical reason is when a baby's head strikes the mother's pelvic bone during delivery. This occurs when the head is pushed by the power of the contractions until it enters the delivery canal.
Utilizing labor aids like vacuum extractors and obstetrical forceps during labor is another frequent reason for head trauma. When a mother's uterine contractions are insufficient to force the baby through the delivery canal, these medical instruments are helpful. These tools are used by doctors in the delivery room to grasp the baby's head, and they have the potential to exert enough force to rupture the blood vessels in the baby's head.
The following risk factors raise the pressure on the fetus's head and the possibility that the newborn will develop a cephalhematoma:
-
Lengthy labor.
-
Labor's second stage is taking a long time.
-
Weak or inefficient contractions of the uterus.
-
The fetal presentation is abnormal.
-
Instrument-assisted delivery using vacuum extractors or forceps.
-
Multiple pregnancies.
These elements contribute to the delivery process's traumatic effect on the fetus's head.
What Are the Symptoms of Cephalohematoma?
The most typical symptom is a soft lump or bulge on the baby's skull in the back. The skin over the protrusion would not typically show any bruises, wounds, or reddening.
Cephalohematomas might be large or small, apparent or not apparent. The bump feels soft at first, but as the blood pools start to calcify, it gets harder and denser. After a few weeks, the bulge begins to recede. Typically, the center of the bump disappears before the edges, giving it a "crater-like" appearance. It is a signal that the mending process is succeeding.
What Are the Potential Complications of a Cephalohematoma?
-
Calcification of a Cephalohematoma: A neonatal cephalohematoma may develop calcification if it persists for longer than a month. Calcification is the formation and hardening of bone deposits around the blood pool. Although it seldom happens, cephalohematoma calcification can seriously damage the skull.
-
Anemia: Red blood cell shortage is the main cause of anemia. Anemia may arise from blood loss because infant cephalohematoma pools a large volume of blood.
-
Skull Fracture: Skull fractures are a more frequent consequence of infant cephalohematoma. Even though fractures happen in over 25 % of instances, they are typically not extremely dangerous and frequently heal without requiring much medical assistance.
-
Jaundice: An excessive amount of bilirubin, a chemical waste product produced by degenerated blood cells, is what causes jaundice. Normally, bilirubin is excreted by the liver and urination. Jaundice typically causes a baby's skin and eyes to appear yellow. Jaundice that is left untreated can result in kernicterus, a dangerous illness that can harm the brain and even result in death.
-
Infection: Infection is one of the more serious side effects of neonatal cephalohematoma. A serious systemic infection, such as sepsis or meningitis, can start in the blood that has accumulated and becomes infected. Infant mortality rates for these dangerous diseases are high; therefore, it is crucial to get it detected right away.
How to Diagnose Cephalohematoma?
The baby will undergo a full-body examination by their doctor in order to identify cephalohematoma. Often, a diagnosis can be made based just on how the bulge appears.
The doctor might order extra tests as a precaution, such as:
-
An X-ray.
-
CT (computerized tomography) scan.
-
Ultrasound.
-
MRI (magnetic resonance imaging).
The doctor will manage the area as cephalohematoma if these imaging tests do not show any additional issues. However, it is important for the parents and the doctor to keep an eye out for any changes in the baby's symptoms or other warning indications of issues.
How to Treat Cephalohematoma?
Depending on the infant's particular needs, the doctor may suggest a number of treatment choices after newborn cephalohematoma has been detected in the child. With time and rest, mild infant cephalohematoma instances resolve on their own. Surgery may be necessary for more serious hematomas. Surgery may be advised by a doctor to get rid of blood clots, stop veins from bleeding, or drain extra blood after injuries. A child's overall development can be protected from serious problems with the proper treatment.
Conclusion:
A clinical diagnosis, cephalohematoma is typically a benign postpartum complication. However, the parents should be informed about the significance of monitoring the baby for the first week by the nurse, obstetrician, and delivery nurse before being discharged. The baby should be watched for any behavioral changes, feeding issues, emesis (vomiting), and underdevelopment. The majority of newborns recover without incident. The best patient education and successful outcomes will be delivered through an interprofessional team approach.
