➤ Cephalohematoma in a newborn - causes and consequences.

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Cephalohematoma is a hemorrhage that is located between the flat bones of the skull and the periosteum surrounding the bone, and is expressed by swelling on the head. The surface of the skin in the area of the tumor projection does not change, its color remains the same, however, pinpoint hemorrhages can be detected on it.

Cephalohematoma occurs in approximately 0.4-0.5% of the total number of newborns.

Every child has birth trauma to one degree or another. It is the result of the birth process, in particular, the mechanical interaction of the fetus and mother. And cephalohematoma is often confused with a birth tumor, which is characterized by swelling of soft tissues of various locations (usually the part of the fetal body that passes through the birth canal first, most often the head). This occurs due to the fact that the hard bones of the fetal skull are pressed against the mother’s pelvic bones, as a result of which the outflow of blood is disrupted (the integrity of the blood vessels is not compromised!). The birth tumor is not limited to the bones of the skull, has a jelly-like consistency and resolves on its own within 1-2 days of the child’s life.

Video with explanations from a neurosurgeon

A guest of Evgeniy Komarovsky’s television studio, a pediatric neurosurgeon, talks about the effectiveness of various methods for correcting the shape of a newborn’s head and answers common questions about cephalohematomas.
Parents are primarily responsible for children's health. And literally every decision they make somehow affects the health of the baby. It is difficult to decide whether to do a puncture during CFG or wait, but it is also difficult to decide when, for example, it is better to introduce the first complementary foods, and what foods to start with, so as not to undermine the imperfect digestive system.

Specifics of child care

Cephalohematoma on the head of a newborn requires special care for the child. It is not recommended to rock the child; he should be provided with complete rest and daily medical supervision.

If the baby has undergone surgery, there is always a risk of recurrent effusion, so the mother should also refrain from rocking the baby for 6 months. If there were complications of a neurological nature, affecting areas of the brain, then after rehabilitation the child’s development should be monitored by a neurologist.

Author: Gertrude Johnson

Article design: Mila Friedan

How is it diagnosed?

The main diagnostic technique is an external examination of the child’s scalp. Large cephalohematomas can be visually identified at the first glance at the baby. Smaller hemorrhages require careful palpation. Additional research methods are used:

ultrasound examination - it is used to determine the size of the hematoma and bone fractures;
X-ray of the skull - in two projections reveals changes in bone tissue (fractures, cracks, displacement).

Differential diagnosis is carried out with the following diseases:

cerebral hernia;
subgaleal hematoma;
birth tumor.

Computed tomography is the most accurate research method; it can be used to reliably identify cephalohematomas at the stage of ossification. However, this method exposes the child’s body to radiation, so it is recommended only if there are strict indications.

Follow-up therapy

Further treatment depends on the type of bruise. To speed up the resorption of cephalohematoma, the doctor may prescribe Troxerutin ointment or Troxevasin gel. The drugs increase vascular tone and accelerate the resorption of bruises. Directions for use: treat the affected area no more than twice a day.

If the bruise is large (more than 100 ml in volume) or the hematoma does not decrease in size, and the baby’s condition worsens every day, aspiration is performed. Removal of a cephalohematoma occurs using two special needles. One is used to pump out blood, the second is used to maintain normal pressure in the vacated cavity.

Cephalohematoma puncture is a safe and effective treatment method. On the same day, the child is transferred to the general ward. His condition is improving, he is becoming more active and mobile.

For intracerebral, epidural and subdural hematomas, surgical intervention is often performed, after which the attending physician can prescribe drug rehabilitation therapy to the newborn.

Puncture of a hematoma is an absolutely safe procedure, after which the baby becomes active and is no longer bothered by the symptoms characteristic of the disease.

If the doctor recommends surgery, you should not refuse.

In the video, a pediatric neurosurgeon talks about what a cephalohematoma is and what the tactics of parents and doctors should be. You will also learn the expert opinion of doctors about one of the ways to straighten the irregular shape of a baby’s head.

Treatment of cephalohematoma

For small hemorrhages (up to 8 cm), treatment is not carried out. Such hematomas resolve safely on their own without any intervention from a doctor. In some cases, the doctor may prescribe vitamin K and calcium supplements for better resorption of the formation. To prevent complications, parents should provide their baby with peace. You should not rock a newborn in a cradle or stroller - this may slow down the spontaneous resorption of the cephalohematoma.

You need to bathe your child very carefully so as not to injure the delicate skin or cause an infection. If all recommendations are followed, a small cephalohematoma disappears within two to three weeks

Treatment of cephalohematoma is carried out if the size of the hemorrhage exceeds 8 cm, as well as when it develops suppuration or ossification. Any therapy is carried out in a specialized hospital. A puncture is performed to remove blood from large hematomas. During the manipulation, the doctor punctures the formation with a thin sterile needle, and then removes the accumulation of blood. After the procedure, a tight bandage is applied to the site of the hematoma. The puncture is well tolerated by newborns, but, like any surgical procedure, it requires the attention of a specialist. After the puncture, the baby is under the supervision of a pediatric surgeon and neonatologist for some time, after which he is discharged home.

Puncture of cephalohematoma is performed only according to strict indications. If possible, doctors try to do without such serious interventions in the little man’s body. However, you should not delay surgical treatment. The postponed puncture does not have an adverse effect on the baby’s development, so you should not be afraid of it and refuse treatment. If the baby is not helped in time, the hematoma will inevitably lead to the development of sepsis and other dangerous complications.

Treatment of a festering hematoma also takes place in a hospital. During the procedure, the surgeon opens the formation, removes pus and excess blood. The wound is washed with antiseptics, after which a sterile bandage is applied. After surgical treatment of cephalohematoma, antibacterial therapy is mandatory. The duration of treatment is about 7 days, after which the child is discharged home under the supervision of a local pediatrician.

Prevention of the development of cephalohematoma consists of careful management of labor and choosing the optimal method of delivery. If there is a pronounced discrepancy between the sizes of the fetal head and the mother's pelvis, the issue of performing a cesarean section is decided. This measure allows you to avoid the appearance of cephalohematoma and other injuries that occur during natural childbirth.

Treatment

To date, there are no clear clinical recommendations on how neonatal cephalohematoma should be treated. Most neonatologists are of the opinion that conservative treatment is necessary. This is especially true in the case of small formations that are not accompanied by any complications.

Indications for surgical treatment of cephalohematoma may include:

the presence of complications, including bacterial;
no regression of education by the tenth day of the baby’s life;
the presence of a cosmetic defect with the spread of cephalohematoma to the face;
very large hematoma.

Surgical treatment of cephalohematoma in an infant consists of puncturing it and removing the spilled blood. Usually the puncture is performed on the seventh day of the child’s life. In the earlier period, it is not recommended to perform any surgical procedures, as this may lead to bleeding. After puncture of a cephalohematoma in a newborn child, a pressure bandage is applied to the intervention area.

Surgical treatment significantly reduces the risk of infection or ossification of the hematoma and is a good prevention of complications.

Folk remedies are ineffective in this case or are at best a placebo. Moreover, you should not use methods such as vodka compress. According to doctors, you should not smear a cephalohematoma in a newborn child with any ointments, for example, such as “Troxevasin” or heparin ointment, especially without consulting a doctor. There are recommendations for the use of homeopathic remedies (Traumel S) to speed up the process of hematoma regression. Whether or not you can use this drug, it is better to check with your doctor.

A hematoma on the head of a newborn child is a consequence of a number of pathologies on both the mother and the fetus. In some cases, it can be combined with damage to the central nervous system, and therefore requires careful diagnosis, consultation with a neonatologist and neurologist. Modern treatment methods allow for faster regression of the formation and reduce the risk of complications.

Types of cephalohematomas

Cephalohematoma on the head of a newborn, the consequences of which have various types of further rehabilitation, during diagnosis is classified by diameter, by the degree of trauma and by location on the baby’s head. Locally, the hematoma can be located on the parietal part of the skull, on the frontal, temporal and occipital parts.

Regarding the size of the hematoma, there are three grades:

Grade I corresponds to a hematoma diameter of up to 4 cm;
Grade II corresponds to a diameter from 4.1 to 8 cm;
Grade III corresponds to a diameter exceeding 8 cm.

According to the degree of injury, cephalohematoma can be:

in combination with a skull fracture;
penetrating the brain, which is defined as cerebral edema;
hematoma in combination with neurological symptoms.

Causes of cephalohematomas

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

Cephalohematoma appears on the head of newborns as a result of mechanical injuries that occur during the process of hemorrhage. The causes of tumor formation are related to both the fetus and the mother in labor, so they are divided into two types.

From the parturient side:

Age over 30 years. During this period, a woman’s body is considered less adapted to childbirth. The ovaries decrease their activity. 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 pelvic organs, this can reduce the quality of labor and harm the fetus.
Weak labor. Due to endocrine diseases or pathology of the uterine walls, the cycle of contractions is disrupted or weakened, which can provoke birth injuries.
Pelvic anomalies. This feature of the body occurs in 7% of women. Combined with the baby's large head, a narrow or deformed pelvis causes birth injuries or abnormal fetal positioning.

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

Causes of tumor formation on the part of the fetus:

Abnormal position. This phenomenon is observed even during pregnancy. In such cases, pregnancy proceeds under the strict supervision of a doctor. Most often, if the fetus is abnormally positioned, a caesarean section is performed.
Large fruit. After the cervix opens, the head of a large baby may not pass through. This causes prolonged labor.
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 outdated and is practically not used.

The main causes of the disease

The main cause of cephalohematoma in newborns on the head is the trauma suffered by the child, which he received during childbirth. This usually occurs in pathological births when assisted delivery methods are used. Often this pathology is diagnosed in children who have had obstetric forceps applied. It can also occur after vacuum extraction. In this regard, this pathology belongs to the category of birth injuries.

Often, a cephalohematoma in newborns on the head is formed during the passage of the child through the birth canal. But sometimes it also occurs in cases of cesarean section. Sometimes hematomas in the skull area are diagnosed even against the background of a normal birth process.

Among other things, the causes of pathology can be:

The baby's weight is too high.
The presence of fetoplacental disorders, for example due to diabetes.
Too long or, conversely, rapid labor period.
The presence of pathology of the pelvic bones in the mother. For example, a narrow pelvis.
The mother has chronic somatic diseases.

We have described the causes of cephalohematoma in newborns. In the next section we will talk about diagnostics.

Cephalohematoma in a newborn - consequences

The prognosis for this pathology is favorable: cephalohematoma does not affect the development of the child and his intelligence.

Consequences that may occur in a newborn:

• ossification;

• anemia;

• jaundice;

• suppuration.

Ossification

A week after birth, dense connective tissue may grow at the site of the hematoma. As a result, the skull bone is deformed, since the resulting tissue has a high density. But this is only a cosmetic defect that does not affect health. It will be completely invisible in an adult.

Anemia

If the hematoma is large or if there are several formations, posthemorrhagic anemia may develop. This is due to the small volume of blood in the newborn, which is significantly affected by any loss. There is no treatment for such anemia: as a rule, hemoglobin is restored to normal over time without taking special medications.

With the breakdown of red blood cells, hemolytic anemia develops with its external manifestation in the form of jaundice.

Jaundice

In cases where the cephalohematoma is enormous in size and quickly resolves, red blood cells disintegrate. The level of bilirubin in the blood increases, and hemolytic anemia develops. Since metabolic processes are slowed down, for some time the skin and mucous membranes have a slight icteric coloration. In such cases, special therapy is not prescribed; the condition normalizes on its own.

Suppuration

One of the rare but dangerous complications is suppuration, which occurs when the integrity of the hematoma is damaged and becomes infected. It is dangerous because the inflammatory process can spread to brain tissue. If suppuration occurs, the condition of the newborn worsens: body temperature, the child becomes lethargic and restless. The skin over the hematoma becomes inflamed, red, swollen, and painful. When palpated, it causes anxiety and crying.

If such a complication develops, an emergency operation is performed: autopsy, drainage, and then a course of local anti-inflammatory therapy. If the pathology is detected in a timely manner, everything goes away without consequences for the child’s health.

Signs and complications

Before treatment, you need to understand the symptoms of the pathology in order to understand how it manifests itself. In the first stages of the disease, there are no obvious signs of cephalohematoma. However, then the following signs appear, indicating the emergence of pathology:

Spots with borders of blood effusion.
Increase in tumors two and a half times. The size of the formations increases periodically, and not constantly. Therefore, their sizes can continuously increase for 2–3 days and then remain unchanged for a week.
A slight swelling on the baby's head.
Deformation of the skin over the site of hemorrhage.

There are four serious complications that appear if cephalohematoma is not treated:

Anemia. The complication appears after the loss of a large amount of blood.
Jaundice. When the hematoma increases 3-4 times, blood will gradually begin to enter the tissues located in the periosteal cavity. Once in the tissue, hemoglobin in the blood is divided into particles and bilirubin begins to be released. The entry of this substance into the circulatory system is accompanied by the main symptoms of jaundice.
Suppuration. The most serious of all complications is considered to be suppuration that appears after infection enters the area of hemorrhage. The development of complications is accompanied by swelling and redness of the skin. Sometimes newborns' body temperature rises and headaches appear. Cephalohematoma with suppuration will have to be treated surgically.
Deformation and damage to the cranial bones after an enlarged hematoma.
Inflammation that damages the brain and nearby tissues.

Main symptoms and diagnosis

It is impossible to detect such an injury immediately after the baby is born due to the birth tumor. If after 2-3 days there are still swellings on the child’s head, he is prescribed tests. There are cases when cephalohematoma in newborns appears later.

During childbirth, the bones of the fetal head are compressed and the periosteum is displaced. Sometimes this leads to damage to blood vessels in these areas. Due to the fact that in newborns the blood clotting mechanism has not yet formed, it accumulates between the periosteum and bone and remains liquid.

To diagnose birth injuries, a visual examination is performed. If the hematoma is small and does not continue to grow, other diagnostic procedures are not needed.

Additional research methods are used if:

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

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

If the baby exhibits the above symptoms, additional tests are carried out:

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

After a complete examination, the child is prescribed treatment.

Diagnostic methods

Diagnosis of cephalohematoma begins with examination of the affected area. Then additional diagnostic measures are prescribed:

Ultrasound (determining the size of the formation, identifying a skull fracture, hernia);
X-ray examination (for detailed visualization if a fracture is suspected);
laboratory tests - for cephalohematoma, general blood and urine tests and a coagulogram are performed;
studies to exclude more serious diseases.

Signs and causes of occurrence

In the first days after birth, a birth tumor is present on the baby’s head. After its convergence, the symptoms of a cephalohematoma become more pronounced and it can be seen with the naked eye.

It looks like a swelling, elastic to the touch. There may be slight redness in the affected area, similar to a bruise, which subsequently darkens and turns yellowish-brown. A compaction can be felt along the edges of the tumor. The shape of the skull may change noticeably. In the first week, the swelling may increase slightly as uncoagulated blood continues to flow under the skin, and then it begins to gradually subside.

The causes of such a tumor in newborns can be various factors:

hardening of the skull bones due to delayed delivery;
fetal malformations;
rapid labor;
late pregnancy;
mechanical injury during childbirth;
malposition;
difficulty passing the fetal head due to a discrepancy in the size of the woman’s pelvis;
injuries to the pelvic bones of a woman in labor;
large size of the fruit;
umbilical cord entanglement and hypoxia.

Cephalohematoma in a newborn is more common in multiparous women. The consequences of such a violation can be dire.

Causes

During childbirth, the bones of the newborn’s skull are able to overlap each other, since between them there are cartilaginous areas - fontanelles. Against this background, there is a narrowing of the volume of the baby’s head, due to which it is subject to slight deformation. Forty-eight hours after birth, the baby's head becomes normal again.

When the bones of the head are displaced, the periosteum also begins to change its position, leading to rupture of the vascular walls. In most cases, the formation of a bump on the head occurs in babies whose bodies lack the following vitamins PP, C and K.

The blood flowing from the vessels forms stagnation in the pocket-like depressions between the periosteum and the flat cranial bones. This is where the lump tumor forms.

There are also other causes of cephalohematoma in infants:

narrow female pelvis;
pathological development of the embryo;
defects during fetal formation;
walking around a pregnant woman;
slow or rapid labor;
presentation of the facial, parietal or pelvic types;
big baby.

These are the most common factors leading to the formation of lump-like neoplasms on the head of newborns. This should also include the chronic type of intrauterine fetal hypoxia. The reason for this is the compression or entanglement of the umbilical cord around the neck, resulting in asphyxia. This condition is characterized by the retraction of the baby’s tongue and the accumulation of a large amount of mucus in his mouth.

Advice!

The birth cone must be treated, as it can develop into a more serious disease.

Often, neoplasms are the result of careless actions of obstetricians and gynecologists during complicated labor.

In this case, a vacuum or forceps are used. Be that as it may, the presence of the described illness requires showing the baby to a pediatrician.

What is a cephalohematoma?

Cephalohematoma is a type of hemorrhage in the tissues of the skull of a newborn who has suffered a birth injury. As it passes through the birth canal, the child’s skull, which is not yet a full-fledged solid bone, narrows and elongates.

As a result of excessive pressure, the periosteum is stretched along with the scalp, and the vessels located at the point of pressure burst, causing bleeding.

The blood at the site of the rupture does not clot due to the lack of a sufficient number of platelets in the child’s body, and continues to accumulate, filling the space between the periosteum and the bone. The volume of accumulated blood can vary from 5 to 150 ml.

Cephalohematoma in newborns and its consequences

Ossification of cephalohematoma

7 days after the occurrence of a cephalohematoma, it may be replaced by dense connective tissue, resulting in bone deformation. The defect is only cosmetic and does not pose any harm to health. When the child grows up, the defect will not even be noticeable.

Anemia

If the cephalohematoma is large enough, the baby may experience posthemorrhagic anemia. Since the child's circulating blood volume is small, hemorrhage can cause changes in the peripheral blood.

Jaundice

With a large size of the cephalohematoma and with its rapid resorption, the breakdown of red blood cells increases, which leads to an increase in bilirubin.

The baby’s body does not have time to completely remove it, and bilirubin is deposited in soft tissues, causing the skin and visible mucous membranes to turn yellow. This condition is temporary, similar to physiological jaundice and does not require additional treatment.

Suppuration of cephalohematoma

If the cephalohematoma is sedimented or damaged, it may become infected and form a purulent process. This complication is rare, but one of the most dangerous. After all, the inflammatory process of the soft tissues of the head in a newborn can easily spread to the brain tissue.

When suppuration occurs, the skin over the hematoma becomes red and swollen, there is an increase in body temperature to 38 degrees Celsius, the child becomes lethargic, appetite decreases, and when palpating the cephalohematoma, severe anxiety occurs.

If a cephalohematoma becomes infected, an emergency operation is indicated - opening the abscess. The purulent cavity is sanitized and drained, and local anti-inflammatory therapy is prescribed. If you seek medical help in a timely manner, all negative consequences can be avoided.

The cephalohematoma itself is not dangerous for the child. It does not affect the nervous system in any way and does not cause delays in neuropsychic development. But the large formation on the baby’s head causes him discomfort, so special care should be taken for a newborn with a cephalohematoma.

Firstly, you must follow all the doctor’s prescriptions; you should not resort to independent treatment methods. Otherwise, instead of resolving the hematoma, you may end up with increased hemorrhage. It is necessary to treat the newborn with special care, avoiding any damage to the head. Caps and caps should not be tied tightly on the baby’s head, so as not to create additional discomfort. It is important to monitor the size of the hematoma over time. If there is a progressive increase in size, consult a doctor. To make sure your child sleeps comfortably, there are special pads that evenly distribute pressure between uneven areas of the head. By following all these simple rules, you will reduce the child’s discomfort and reduce the risk of complications.

By following all these simple rules, you will reduce the child’s discomfort and reduce the risk of complications.

Cephalohematoma in newborns: consequences and development of the condition

Immediately after the baby is born, it is impossible to determine whether the swelling is a natural condition or whether blood is accumulating under the skin. When pressing on the tumor area, you can feel the movement of liquid under your hand, along the circumference of which there is an elastic roller. Removal of cephalohematoma in newborns is not always done: if the volume of blood accumulated during childbirth and for 2-3 days after it is not too large, after the first week of the baby’s life the tumor will begin to decrease and resolve itself.

Cases have been recorded in which fairly large volumes of blood were resorbed without any medical intervention. But it is necessary to understand that in this case, the surrounding tissues may become saturated with blood, which will lead to an increase in bilirubin in the blood and prolonged physiological jaundice. This development of events is dangerous because the hematoma can ossify, the bone grows because of this, and the child develops asymmetry of the skull bones or its deformation, which is often not detected in the first weeks of the baby’s life.

Diagnosing cephalohematoma in newborns, reviews confirm this, is not difficult. If the tumor on the baby’s head does not go away within the first 48 hours of life, he is prescribed an ultrasound examination of the skull. An ultrasound can rule out cerebral hernia, bone defects and confirm that blood is accumulating under the skin. In addition, ultrasound makes it possible to assess the size of the damage and its boundaries.

How does it arise

A cephalohematoma is a hemorrhage under the periosteum in the skull area. The mechanism of its occurrence is due to external pressure on the skull and displacement of the soft tissues of the scalp. During such movement, the connective tissue fibers connecting the periosteum and bone are ruptured. This leads to stronger tissue movement, tension and rupture of small vessels in the area. A hematoma is formed, which can have different sizes or shapes. Cephalohematoma can be:

focal - when it represents a local elevation above the surface of the skull;
widespread - localized in most cases within one skull bone.

Some children are diagnosed with several such hematomas. Sometimes there is a combination of widespread and focal forms of pathology.

The formation of a cephalohematoma usually occurs in the first two to three days after birth. This is caused by a deficiency in the child of certain blood clotting factors, and in some cases by insufficient vitamin K. Less commonly, the pathology is detected immediately after birth. Delayed hematomas, that is, those occurring in a later period of life, indicate the presence of serious metabolic disorders or systemic diseases in the child. Depending on the size, there are three degrees of hematoma in the skull area:

first – the size of the hematoma does not exceed 4 cm;
second – the diameter of the hemorrhage focus is 4-8 cm;
third – hematoma more than 8 cm.

Treatment of cephalohematoma in newborns

Cephalohematoma can be located in different parts of the head, but most often it is observed in the crown area, less often in the occipital, frontal or temporal regions. The boundaries of the tumor usually do not extend beyond the sutures of the skull, where the periosteum is tightly fused to the bones. The blood in a cephalohematoma remains liquid for a long time and does not clot, so the consistency of the formation is initially elastic. Upon palpation, you can feel the movement of fluid inside.

If the amount of blood in a cephalohematoma in newborns is small, then after a few days it begins to decrease in size and dissolve. The tumor completely disappears after about one and a half to two months without any intervention. If significant hemorrhage occurs, resorption may take a longer period of time.

For small cephalohematomas in a newborn, treatment is usually not required. Doctors monitor the child and sometimes prescribe him vitamin K, which increases blood clotting. This is done to stop the leakage of blood and the increase in tumor size. To avoid complications, it is recommended to feed the baby with breast milk, which contains maternal antibodies and contributes to the formation of his own immunity.

If the size of the hemorrhage is significant, puncture of the cephalohematoma in newborns is performed. Using a special needle, punctures are made in the periosteum, through which the contents of the formation are sucked out. Then a pressure bandage is applied to the damaged area. For pain relief and hemostatic purposes, it is recommended to apply Traumeel S ointment to this area of the head several times a day.

If inflammation of the cephalohematoma, its redness, swelling, and increase in body temperature are observed, this means that infection and suppuration are occurring. In this case, instead of puncture of the cephalohematoma in newborns, surgical intervention is required. The skin at the site of tumor formation is cut, after which the blood accumulated there is removed and the edges of the wound are sutured. Subsequently, antibiotic therapy is carried out. After the operation, the child is under medical supervision for several months.

Symptoms and classification of cephalohematoma in newborns

In almost all children, in the first days after birth, the head looks a little swollen. You can talk about the symptoms and diagnosis of cephalohematoma only on the second or third day after birth.

Symptoms of cephalohematoma in a newborn:

A tumor on the head, which is determined visually. This place can pulsate and enlarge, as the blood, without coagulating, continues to fill the formed cavity.
Redness of the swollen area. After some time, the swelling may turn yellow or brown.
Seals along the edges of the tumor.
Changing the shape of the skull.

Most often, newborns are diagnosed with the second or third degree.

Depending on the size of the cephalohematoma, the following is determined:

First degree. When the tumor diameter is less than 4 cm.
Second degree. The diameter of the formation is from 4 to 8 cm.
Third degree. The tumor is more than 8 cm in diameter.

Based on the number of formations, cephalohematoma is distinguished:

single;
multiple.

Depending on the location, a cephalohematoma can be:

parietal;
frontal;

occipital;
temporal

Most often, the tumor appears in the parietal and frontal parts of the skull. Less often - in the occipital region.

Depending on the damage that can sometimes accompany cephalohematoma, there are:

cephalohematoma with skull fracture;
cephalohematoma with brain damage (edema, cerebral hemorrhage).

Therapeutic assistance for hematomas in children

In most cases, intracranial hemorrhages do not pose a threat to life or health. Typically, this type of formation resolves on its own within 7-14 days after its appearance.

But there are some cases when hematomas on the head of newborns do not disappear on their own; when they will go away and how successful the recovery process will be depends on the complexity of the formations and on the correct treatment carried out on time.

Depending on the type and location of the bruise, doctors may prescribe various drugs as auxiliary therapy, the action of which is aimed at accelerating the process of resorption of hematomas. The most commonly used medications are Troxevasin gel or Troxerutin ointment. The frequency and dosage of use are prescribed by the attending physician.

When the bruises are large and contain more than 100 ml of accumulated fluid, then aspiration is the best treatment option. These are completely safe manipulations and after they are carried out, the hematoma on the head is completely eliminated as quickly as possible and without harm to the child’s body. When recovery comes, the child develops fully and is not threatened by any consequences.

Remember the main thing! Whatever the hematoma on the head of a newborn, it must be shown to a qualified specialist. Typically, such pathologies are discovered in the maternity hospital during an examination of the child by an obstetrician. But if you have been discharged home and you notice any deterioration in your baby’s well-being, then you should not self-medicate.

Your attentiveness and responsibility directly determine what consequences a hematoma on a newborn’s head will cause, when the pathology goes away and how quickly your baby will recover.

Why do newborns develop cephalohematoma?

The causes of cephalohematoma are related to the process of childbirth and the structural features of the body of newborns. The injury itself can be triggered by a number of external reasons, both through the fault of doctors and the fault of the mother.

The medical factor is associated with intervention in childbirth, when doctors, to help the woman in labor, use tools to help get the baby out if it gets stuck in the birth canal, or the birth is difficult for the mother, and medical intervention is necessary. In modern practice, tools such as forceps and vacuum extraction are no longer used.

Cephalohematoma on the head of a newborn, the consequences of which causes a number of diseases in the future, becomes the result of certain factors related to the condition of the mother and the characteristics of her body.

In some cases, a woman (usually only 7% of women) has a natural pelvis that is not wide enough for the baby to pass through, this is considered an anomaly, in such cases it is best to have a caesarean section to prevent the risk of injury to the baby.

If a woman suffered any pelvic injuries before giving birth, which caused improper fusion of bones, if there were fractures, this resulted in exostosis, that is, excessive growth of cartilage tissue at the site of a crack or fracture. And also in case of bone disease, when the bones are brittle or too hard, which also affects their natural expansion during childbirth.

Another factor is insufficient elasticity of the uterus. This may be due to the age of the woman in labor, when the activity of the ovaries decreases with age, due to hormonal disorders or the natural subsidence of hormonal activity, which gives the effect of loss of elasticity of the uterus and vagina.

Cephalohematoma in newborns - treatment

With timely treatment and proper care for the child, the prognosis for this disease is completely favorable. Treatment of cephalohematoma in newborns is carried out depending on the degree of the tumor.

A small cephalohematoma does not require any special intervention and usually gradually goes away on its own. Sometimes the doctor may prescribe special ointments that speed up the resorption process.

In the vast majority of cases, cephalohematoma in newborns resolves within a period of two to four weeks, says pediatric doctor Komarovsky. But at the same time, parents still need to monitor the child’s condition and see a doctor.

If a newborn has a second-degree cephalohematoma, treatment can be conservative.

In a complex of medications, the doctor prescribes:

vitamin K;
calcium preparations;
drugs that increase blood clotting.

In the third degree of cephalohematoma, surgical intervention is required, during which a puncture is performed and the contents of the hematoma are pumped out through a needle. To prevent re-bleeding, a tight bandage is placed on the child's head.

The indication for urgent surgery for cephalohematoma of any degree is tumor suppuration. In this case, during the operation, purulent fluid is pumped out of the tumor and the resulting cavity is sanitized.

During the postoperative period, various ointments, anti-inflammatory and antibacterial agents are used. The healing process depends on the child's condition and usually lasts from one week to a year.

During treatment, the child needs to be provided with complete rest and proper care:

Avoid playing too vigorously with your baby, which could accidentally injure the tumor site.
Don't rock your baby.
Be sure to monitor the size of the hematoma. If the tumor begins to enlarge, seek medical help immediately.

If there are indications, you should not refuse treatment, including surgery. Puncture of cephalohematoma in newborns is carried out very quickly and absolutely painlessly.

Untreated cephalohematoma on the head of a newborn can have various negative consequences:

Fluid from the damaged area will fester over time and will penetrate and affect other tissues.
Jaundice and anemia appear as a result of the breakdown of hemoglobin.
Ossification (hardening of tissue), which leads to deformation of the skull.

Consequences of cephalohematoma in newborns on the head

For most children, the prognosis of this disease is favorable; in eighty percent of cases, cephalohematoma can go away without a trace. As a rule, during the first week the hematoma regresses, completely disappearing after two to three weeks. Very rarely, a cephalohematoma does not resolve, resulting in the process of ossification. Over the course of several weeks, a dense capsule forms in the area of the spilled blood. In the future, the following development options are possible:

Bone tissue can fuse with a dense capsule.
A cavity forms at the site of the blood clot.
After the cephalohematoma is reduced, bone tissue defects form.
The hematoma completely resolves, but defects in the skull bones form in this area.

Among other things, the consequences of cephalohematoma can manifest themselves with the following symptoms:

The appearance of jaundice in newborns, which is caused by the breakdown of spilled blood and an increase in the level of bilirubin in it.
The occurrence of anemia, which occurs due to the accumulation of a certain amount of blood in the area of the hematoma.
The occurrence of bacterial complications due to suppuration of the hematoma.
The process of osteolysis is the softening of the area of bone that is adjacent to the hematoma.

What is the treatment for cephalohematoma in newborns?

Consequences of cephalohematoma

Why is this hemorrhage dangerous? Most often nothing. In the vast majority of cases, there are no consequences of cephalohematoma in a newborn, and at an older age it is impossible to say that the child had this complication of childbirth in the past.

However, with cephalohematoma, the following complications may occur:

Anemia - develops with severe blood loss;
Jaundice - due to the breakdown of hemoglobin with the formation of bilirubin;
Suppuration - when bacteria enter the tumor through damaged skin;
Ossification (ossification) of cephalohematoma - due to the deposition of calcium salts in the cavity.

Since blood accumulates above the bones of the child's skull, it cannot damage his brain and other parts of the nervous system.

It is quite easy to recognize this pathology - there are characteristic external signs for this, so instrumental and laboratory diagnostics do not have any significance. Treatment for cephalohematoma is chosen by the doctor together with the child’s mother. Regardless of the tactics (surgical or conservative), hemorrhage is successfully treated and, most often, does not leave any consequences for the child.