Cephalohematoma in a newborn is a hemorrhage that forms between the periosteum and cranial bones. This disease is the most common birth injury. It usually occurs in three out of a thousand children. In our publication today, we will consider why it develops and how its treatment is carried out. The effects of cephalohematomas in newborns will also be described below.
Disease prevalence
Modern medical advances along with prenatal diagnosis significantly reduce the risks of complications during childbirth. But statistics show that the incidence of birth injuries among newborns remains at a fairly high level, at about five percent.
How does this pathology arise in newborns?
Cephalohematoma in a newborn, as already noted, is a periosteum hemorrhage in the region of the skull. The mechanism of its formation is due to exerting external pressure on the skull, as a result of which the soft tissues of the scalp are displaced. Against the background of this movement, a connective tissue fiber ruptures the periosteum and bone. This leads to stronger tissue movements, and in addition to tension and a significant rupture of small vessels in this area.
As a result of this whole process, a hematoma is formed, which has different sizes and shapes. Cephalohematoma in a newborn can differ in focal nature. In this case, it will be similar to a local elevation above the cranial surface. Kefalogematoma can also be common, while it is localized most often within the same cranial bone. In some babies, several of these hematomas can be diagnosed at once. Sometimes there is a simultaneous combination of a common and focal type of pathology.
Degree of formation of cephalohematomas
The formation of cephalohematomas in a newborn usually occurs in the first three days after birth. This is due to problems in a child with blood coagulability, and in some cases the effect is caused by an insufficient content of vitamin K. Rarely, a pathology is detected immediately after birth. Delayed hematomas, that is, those that occur in later periods of life, indicate that the child has a serious metabolic disorder or systemic disease.
Depending on the size, three degrees of hematoma are distinguished in the region of the skull:
- In the presence of the first degree, the size of the hematoma is not more than four centimeters.
- With a second diameter of the hemorrhage, up to eight centimeters.
- The third degree involves a hematoma of more than eight centimeters.
The main causes of the disease
The main cause of cephalohematoma in newborns on the head is the child’s trauma that he suffered during childbirth. This is usually found in pathological birth, when obstetric methods are used. Often such a pathology is diagnosed in children, in respect of whom the obstetric forceps were 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 occurs in cases of cesarean section. Sometimes hematomas in the region of the skull are diagnosed even against the background of a normal birth process.
In addition, the causes of pathology can be:
- Too much weight baby.
- The presence of fetoplacental disorders, for example, against the background of diabetes.
- Too long or, conversely, a rapid labor period.
- The presence of pathology of the pelvic bones in the mother. For example, a narrow basin.
- The presence of chronic somatic diseases in the mother.
The causes of cephalohematoma in newborns we have described. The next section will talk about diagnostics.
How is this pathology diagnosed?
The main diagnostic technique is an external examination of the head in the area of the scalp. Large cephalohematomas are easily identified visually already at the first glance at the child. Smaller ones require careful palpation. Of the additional techniques, doctors use:
- Performing an ultrasound scan. Thanks to him, the dimensions of the hematoma are determined, and in addition, bone fractures.
- Radiography of the skull. As part of this procedure, doctors detect changes in bone tissue, such as cracks or displacements.
Differential diagnosis is carried out in relation to the following diseases:
- Brain hernia.
- Subponeurotic hematoma.
- Birth tumor.
Symptoms of pathology
Symptoms of hematoma in infants are manifested by the presence of a tumor-like formation on the head. The hematoma usually has clear boundaries. It can be determined in the region of one or more bones. Typically, localization in cephalohematomas is as follows:
- on the parietal bone ;
- occipital bone;
- frontal bone;
- temporal bone, which is extremely rare.
Often after birth, newborns are diagnosed with cephalohematoma of the parietal region. Sometimes it is detected in conjunction with a head injury. Some may have signs of damage to the nervous system. Kefalogematoma sometimes combined with damage to the cervical region of the spine. Often the forefront is the presence of neurological disorders. Less commonly, the following syndromes can be detected:
- The presence of high neuro-reflex excitability.
- The development of cerebrospinal fluid syndrome.
- The development of disseminated neurological symptoms.
The consequences of cephalohematomas in newborns on the head
For most children, the prognosis of this disease is favorable, in eighty percent of cases of cephalohematoma can pass without a trace. As a rule, during the first week the hematoma regresses, completely disappearing after two to three weeks. Very rarely, the cephalohematoma does not resolve, as a result of which the process of its ossification begins. In the area of spilled blood, a dense capsule is formed within a few weeks. Subsequently, such development options are possible:
- Bone tissue can grow together with a dense capsule.
- A cavity forms in the area of the blood clot.
- After reduction of cephalohematomas, defects in bone tissues are formed.
- The hematoma is completely absorbed, but defects in the bones of the skull are formed in this area.
Among other things, the consequences of cephalohematomas can manifest themselves with the following symptoms:
- The appearance of jaundice in newborns, which is due to the breakdown of spilled blood and an increase in its level of bilirubin.
- 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 a softening of the area of the bone that is adjacent to the hematoma.
What is the treatment of cephalohematomas in newborns?
Treatment features
To date, there are no clear clinical recommendations on how to treat cephalohematoma. Most neonatologists believe that conservative treatment is necessary. This is especially true in the presence of small formations that are not accompanied by any complications. As for the indications for surgical treatment of cephalohematoma in newborns on the head, they are as follows:
- The presence of complications, especially bacterial ones.
- Lack of regression by the tenth day of life of the newborn.
- The presence of a cosmetic defect in which the cephalohematoma extends to the face.
- Too large hematoma.
Surgical treatment of this pathology consists in puncture of cephalohematoma in newborns with complete removal of the spilled blood. As a rule, a puncture is performed on the seventh day of the baby's life. At an earlier stage, it is not recommended to perform certain surgical procedures, as this can lead to bleeding. Immediately after the puncture, a pressure dressing is applied to the area of intervention.
Thus, the hematoma on the head of the baby is the result of a number of pathologies of the fetus and its mother. In some situations, it is combined with damage to the nervous system, and therefore requires careful diagnosis, and in addition, consultation with a neurologist and neonatologist. The effects of cephalohematomas in newborns on the head can be very serious. Therefore, this problem should never be left to chance.
Cephalohematoma in newborns: reviews
According to reviews, this pathology is quite common in infants. Timely diagnosis and removal of the neoplasm is important. Modern treatment methods make it possible to achieve rapid regression of the neoplasm, which significantly reduces the risk of complications. It should be noted that any popular methods regarding this disease are absolutely useless.
Nobody has managed to insure their future child from possible injuries during childbirth. But here, every future mother is capable of ensuring his comfortable and proper intrauterine development. Watch your health and the health of your children!