Cephalohematoma: A Common Newborn Condition, But Why?

is cephalohematoma normal in newborns

A cephalohematoma is a blood clot that occurs between the skull and the scalp of a newborn baby, caused by ruptured blood vessels. It is a relatively common condition, affecting between 1% and 2% of all babies during and after birth. The condition is typically the result of a difficult or prolonged vaginal birth, and the use of birth-assisting tools such as forceps or a vacuum extractor can increase the likelihood of it occurring. While cephalohematoma can be alarming for parents, it is generally considered a minor injury that heals without major medical intervention. However, in some cases, it can lead to complications such as infection, jaundice, and anaemia.

Characteristics Values
Occurrence Between 1% and 2.5% of all births
Cause Trauma or pressure to the head during labour or childbirth
Symptoms A soft, unusual bulge on the back or top of the baby's head
Treatment No treatment required in most cases
Risks Jaundice, anaemia, infection, skull deformity, sepsis, osteomyelitis

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Cephalohematoma is a common condition

Cephalohematoma is a relatively common condition in newborns, affecting between 1% and 2.5% of all babies during or after birth. It is a type of bleed or hemorrhage that occurs when small blood vessels in the scalp rupture due to pressure or trauma during vaginal childbirth. This results in a pool of blood forming a mass just underneath the baby's scalp and outside the skull. While it is more common in vaginal deliveries, it can occur in people of all ages and may also happen during assisted births using tools like forceps or vacuum extractors.

The hallmark symptom of cephalohematoma is a protrusion or bulge on the back or top of the baby's head, which typically appears several hours to days after birth. This bulge will initially feel soft but will gradually harden and shrink as the blood calcifies and is reabsorbed. In most cases, the center of the bulge will disappear first, leaving a crater-like appearance. Aside from the visible bulge, infants with cephalohematoma may not display any obvious symptoms or behavioral differences.

Cephalohematoma is typically a minor injury that heals without any major medical intervention. However, it is important to monitor the baby closely as, in some cases, it can lead to other health complications. One of the most common complications is jaundice, which occurs due to increased levels of bilirubin in the blood as the body reabsorbs the blood from the cephalohematoma. Another potential complication is anemia, which can result from significant blood loss in cases of large cephalohematomas.

While cephalohematoma itself does not pose a direct risk to the baby's brain, as it occurs outside the skull, improper treatment can have serious consequences. In rare cases, cephalohematoma can become infected, leading to more serious health concerns such as sepsis or meningitis (infection of the brain). Therefore, it is crucial for parents to seek medical attention if they notice any unnatural bulging or other concerning symptoms in their newborn.

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It is caused by ruptured blood vessels

A cephalohematoma is a buildup of ruptured blood vessels (a haemorrhage) in the periosteum (the tissue that covers the skull). In other words, it is a blood clot that occurs between the skull and the scalp as a result of ruptured blood vessels.

During childbirth, pressure on the baby's head can cause these blood vessels to rupture, leading to a cephalohematoma. This pressure can be a result of the baby's head being compressed against the mother's pelvis during a difficult or prolonged vaginal birth. The use of birth-assisting tools such as forceps or vacuum extractors can also cause this pressure and subsequent rupture.

The exact location of a cephalohematoma depends on where the ruptured blood vessels are, which is further determined by the baby's position and where the pressure is applied. The pooling of blood from the ruptured blood vessels occurs between the skull and inner layers of the skin, causing unnecessary pooling of blood outside the blood vessels that is visible on the baby's scalp.

While a cephalohematoma is typically benign and self-limiting, resolving on its own within a few weeks or months without intervention, close monitoring is essential to manage potential complications. These include cosmetic deformities, anaemia, infection, jaundice, hypotension, intracranial haemorrhage, and underlying linear skull fractures.

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It is not dangerous for the baby's brain

It is understandable for parents to panic when they notice something unusual on their newborn's head. A cephalohematoma, a lump that may appear on a baby's head, can be particularly worrying. However, it is important to know that cephalohematomas are relatively common and usually not dangerous to the baby's brain.

A cephalohematoma is a collection of blood, or a blood clot, that occurs between the skull and the scalp. It is caused by ruptured or damaged blood vessels, typically due to pressure or trauma during vaginal childbirth. The blood vessels rupture and bleed internally, with the blood collecting into a pool that forms a benign mass under the scalp. This condition typically develops in the hours or days following birth and is more likely to occur during prolonged or difficult labour, or when birth-assisting tools such as forceps or vacuum extractors are used.

While cephalohematoma itself is typically not dangerous to the baby's brain, there are potential complications that can impact the baby's overall health and development. These include:

  • Anemia: Cephalohematoma can cause a drop in red blood cell levels, leading to anemia. This condition can affect the baby's overall health as there are not enough red blood cells to carry oxygen throughout the body. In some cases, a blood transfusion may be necessary to boost red blood cell counts and treat anemia.
  • Jaundice: As the body reabsorbs the blood from the cephalohematoma, the breakdown of red blood cells can lead to increased levels of bilirubin, potentially causing jaundice. While mild jaundice is common and often resolves on its own, severe jaundice can be dangerous. If left untreated, jaundice may lead to kernicterus, a type of brain damage that can result in lifelong disorders like cerebral palsy. Therefore, it is important to monitor the baby closely and seek medical attention if jaundice is suspected.
  • Infection: Although rare, infection of the cephalohematoma site can lead to more serious health concerns, including sepsis, which can affect the brain and other vital organs. Lesions on the skin can increase the vulnerability to bacterial infections, with E. coli being the most common cause of cephalohematoma infections. Fever and inflammation near the site of the bulge are symptoms of infection, and prompt medical intervention is necessary in such cases.
  • Skull Fractures: In some instances, a cephalohematoma may be associated with an underlying skull fracture. While the fracture itself may not directly harm the brain, it increases the risk of other complications, such as an intracranial hemorrhage, which can have serious consequences, including potential damage to the brain.

While most cephalohematomas resolve without major complications, it is crucial to closely monitor the baby and consult a healthcare provider if any signs of concern arise, such as excessive swelling, jaundice, or unusual behaviour.

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Cephalohematoma can cause internal symptoms

Cephalohematoma: An Internal Symptom Causer

Cephalohematoma is a condition that occurs in 1-2% of all live births, and it is characterised by a collection of blood between a baby's scalp and skull. This pooling of blood is a result of ruptured blood vessels, which often occurs during a difficult labour or vaginal birth. While cephalohematoma is typically benign and poses no direct risk to a baby's brain, it can cause some internal symptoms that may lead to potential complications.

Infection

In some rare cases, cephalohematoma can become infected, leading to serious health concerns such as sepsis or osteomyelitis. The majority of cephalohematoma infections are caused by the E. coli pathogen and typically develop within the first or second week after birth. Symptoms of infection include fever and inflammation near the site of the bulge.

Jaundice

Jaundice, a common condition in newborns, is another potential internal symptom of cephalohematoma. As the body reabsorbs the blood from the cephalohematoma, the breakdown of red blood cells can lead to increased levels of bilirubin, which can cause jaundice. While mild jaundice is typically not a cause for concern, severe jaundice can be dangerous and lead to kernicterus, a type of brain damage.

Anaemia

Anaemia is also a common internal symptom associated with cephalohematoma. The pooling of blood caused by cephalohematoma can lead to a decrease in red blood cell levels, resulting in anaemia. This condition can affect a baby's overall health as there may not be enough red blood cells to carry oxygen throughout the body. In some cases, a blood transfusion may be necessary to treat anaemia.

In conclusion, while cephalohematoma itself is typically not a cause for concern, the potential internal symptoms and complications it can cause should not be overlooked. Close monitoring by healthcare professionals and parents is essential to ensure the baby's well-being and to promptly address any issues that may arise.

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It usually heals without medical intervention

A cephalohematoma is a blood clot that occurs between the skull and the scalp of a newborn baby. It is caused by ruptured blood vessels, which can be the result of a prolonged or difficult vaginal birth, or the use of birth-assisting tools such as forceps or a vacuum extractor. This condition affects between 1% and 2% of all babies, and in most cases, it is not dangerous and will heal without medical intervention.

The most common symptom of a cephalohematoma is a soft, unusual bulge on the back of a baby's skull. This may take several hours or days to appear and will usually get harder and denser as the blood begins to calcify. After a few weeks, the blood will start to disappear and the bulge will shrink. In some cases, the centre of the bulge will disappear first, leaving a crater-like appearance.

While cephalohematoma is usually harmless, it can be the cause of more serious health complications in some cases. One potential complication is infection, which can lead to sepsis or osteomyelitis. This is very rare, but it is important for parents to be aware of this risk. Another potential complication is jaundice, which can result from increased levels of bilirubin in the blood as the blood cells break down. Jaundice is a common condition in newborns and often resolves on its own, but severe cases can lead to kernicterus, a dangerous type of brain damage that can cause lifelong disorders such as cerebral palsy.

In most cases, cephalohematoma will heal on its own without any specific treatment. However, in some cases, drainage of the hematoma may be recommended to reduce the risk of abscess formation and infection. If the blood build-up is excessive, a blood transfusion may be necessary to prevent anemia. Babies with cephalohematoma should be carefully monitored by a healthcare provider to ensure that they are healing properly and to watch for any signs of potential complications.

Frequently asked questions

Cephalohematoma is a collection of blood between a baby's scalp and skull, caused by ruptured blood vessels. The blood vessels are often damaged during labour and delivery.

Cephalohematoma occurs in 1-2% of all live births, but this figure rises to 3-4% when birth-assisting tools such as forceps or a vacuum are used.

Cephalohematoma is caused by trauma or pressure to the head during labour or childbirth. The baby's head may hit the mother's pelvic bone during delivery, or the birth canal may be too small, causing the blood vessels in the baby's scalp to rupture.

The most common symptom is a soft bulge or bump on the back or top of the baby's head. This will harden over time as the blood calcifies. Cephalohematoma may also cause internal symptoms such as infection, jaundice and anaemia.

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