Cephalohematoma
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1- Introduction
2- Anatomical Overview
3- Causes
4- Treatment
Introduction
Cephalohematoma is a medical condition that occurs in newborns, usually as a result of trauma during birth. It is characterized by the accumulation of blood between the skull and the periosteum, which is the membrane that covers the bones of the skull. This pooling of blood causes a raised lump or swelling on the baby’s head, typically appearing several hours after birth.
Anatomical Overview
The trauma causes blood vessels between the skull and the periosteum, the membrane that covers the bones of the skull, to rupture, leading to the accumulation of blood. Unlike a caput succedaneum, which is another type of swelling that can occur on a newborn’s head but is located between the skin and the skull, a cephalohematoma is confined by the edges of a single cranial bone. As a result, the blood collects in a well-defined area, creating a raised lump or swelling on the baby’s head. Cephalohematoma is more common in deliveries involving the use of forceps or vacuum extraction, as the pressure from these instruments can cause the blood vessels to rupture. While cephalohematoma itself is not usually harmful and tends to resolve on its own over a period of weeks to months, it can increase the risk of other complications such as jaundice.
Causes
Use of Forceps or Vacuum Extraction: These are medical instruments sometimes used to assist in delivery. The pressure applied by these instruments can cause the blood vessels between the skull and the periosteum to rupture, leading to bleeding and the formation of a cephalohematoma.
Prolonged or Difficult Labor: Babies born after a long or difficult labor are more likely to develop cephalohematoma due to the increased pressure and trauma during the delivery process.
Positioning in the Womb: The position of the baby in the womb, such as being in a breech position or having an unusually large head, can increase the risk of cephalohematoma.
Maternal Pelvis Shape: The shape and size of the mother’s pelvis can also play a role. A narrow pelvis may increase the likelihood of trauma during delivery.
First-Time Mothers: First-time mothers may be more likely to have a prolonged or difficult labor, increasing the risk of cephalohematoma.
Treatment
Observation: Healthcare providers will monitor the cephalohematoma to ensure that it is resolving properly and to watch for any signs of complications, such as infection or jaundice.
Preventing Infection: Keeping the area clean and dry can help prevent infection. In some cases, antibiotics may be prescribed if there is concern about infection.
Managing Jaundice: Cephalohematoma can increase the risk of jaundice, a condition caused by high levels of bilirubin in the blood. Healthcare providers may monitor the baby’s bilirubin levels and provide treatment if necessary.
Pain Management: If the baby is experiencing discomfort, pain relievers such as acetaminophen may be recommended.
Follow-Up Care: Regular follow-up appointments with healthcare providers are important to monitor the baby’s progress and ensure that the cephalohematoma is resolving as expected.