Caput succedaneum

INTRODUCTION Scalp swellings in newborn infants are common in the immediate postpartum period. Unlike caput succedaneum, the most common and short lived variant, cephalhematomas and subgaleal hemorrhages both involve blood accumulation, either under the cranial periosteum or aponeurosis, respectively, and can persist for weeks. However, eventually, they do resolve and do not recur. When an infant comes to medical attention with a new scalp swelling without having sustained postpartum scalp trauma, or with a history of postpartum scalp trauma that had already resolved, the question of whether the infant has sustained a non-accidental injury arises. CASE A fourteen-week-old male presented to their pediatrician’s office after his mother noticed “bumps” on the child’s scalp that same morning. Parents denied history of head trauma, insect bites, changes in behavior, appetite, recent fevers or illness. Birth history was significant in that the patient was born full term via emergency caesarian section after a failed vacuum assisted delivery. Bruising without swelling was noted on the scalp where the vacuum device was applied twice, which spontaneously resolved after several days. Scalp electrodes were also placed intravaginally during labor. On physical examination, there was a 3x3cm swelling noted over the occiput with extension over the right parietal bone. The swelling was fluctuant and mobile without overlying bruising, erythema, crepitus, or observed tenderness to palpation...

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Injuries to the infant that result from mechanical forces (ie, compression, traction) during the birth process are categorized as birth trauma. Factors responsible for mechanical injury may coexist with hypoxic-ischemic insult; one may predispose the infant to the other. Lesions that are predominantly hypoxic in origin are not discussed in this article. Significant birth injury accounts for fewer than 2% of neonatal deaths and stillbirths in the United States; it still occurs occasionally and unavoidably, with an average of 6-8 injuries per 1000 live births. In general, larger infants are more susceptible to birth trauma. Higher rates are reported for infants who weigh more than 4500g. Most birth traumas are self-limiting and have a favorable outcome. Nearly one half are potentially avoidable with recognition and anticipation of obstetric risk factors. Infant outcome is the product of multiple factors. Separating the effects of a hypoxic-ischemic insult from those of traumatic birth injury is difficult. Risk factors for birth trauma include the following [ • Occasionally, injury may result from resuscitation. Recognition of trauma necessitates a careful physical and neurologic evaluation of the infant to establish whether additional injuries are present. Symmetry of structure and function should be assessed, the cranial nerves should be examined, and specifics such as individual joint range of motion and scalp/skull integrity should be evaluated. The birth process is a ble...

Vacuum extraction is one kind of assisted delivery procedure that can help get your baby through the birth canal when labor is stalled in the second stage. The vacuum extractor applies suction and traction to the baby’s head to help pull it out while you push. Vacuum extraction is only recommended under certain conditions. Overview The suction cup applies gentle traction to baby’s head. What is vacuum extraction delivery? During the second stage of Vacuum extraction is one way they can assist. If certain conditions are met — your baby’s head is low enough in the birth canal and they’re in an appropriate position — a vacuum extractor may be able to help guide them out. The vacuum extractor consists of a suction cup attached to a mechanical or electric pump. The cup is applied to your baby’s head and the pump provides traction to pull while you push. It's not always the solution you need, but sometimes it does the trick. Why is vacuum extraction used during delivery? Vacuum extraction, or “ventouse,” is one method healthcare providers use to help get your baby out when they aren’t coming out on their own. There are other methods, including Vacuum extraction and forceps delivery are similar in their advantages and disadvantages, and often the choice between them comes down to the training and experience of your healthcare provider. Both methods carry some risk, but healthcare providers recommend them when the risks of not helping appear to be greater. This might be because ei...

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Caput succedaneum is a medical term describing swelling that occurs to a baby’s scalp shortly after delivery. This Caput succedaneum is quite common, and generally is not a reason for alarm. What is Caput Succedaneum? Caput succedaneum is a type birth injury that causes swelling outside of the skull, but under the scalp and skin of a newborn baby. It often presents as a conehead shape, which can be disheartening for parents. This is different from the swelling that occurs when there is a hematoma on the baby’s head, such as with Caput succedaneum is a relatively common birth injury that occurs during vaginal birth. As the baby moves through the birth canal, there is pressure and compression around the body, including the infant’s head. This pressure can cause fluid buildup, bruising, and sometimes other injuries. This does not indicate a The good news is that the swelling typically resolves within a few days unless there is bruising or additional complications. If bruising is present, the infant is at risk of developing jaundice, which can be dangerous if it is not properly diagnosed and treated. There is also a risk for hair loss (alopecia) in a ring shape around the skull. What Causes Caput Succedaneum? In most instances, caput succedaneum occurs after a long, difficult delivery. The pressure on the baby’s head usually occurs after the membranes break as the baby descends into the birth canal. It is most common when the baby is delivered head-first. That’s because the he...

Caput succedaneum is defined as a diffuse swelling of the fetal scalp caused by the pressure of the scalp against the dilating cervix during labor. Caput is often associated with molding and may extend across the midline (as opposed to cephalohematoma, which does not cross the suture lines). Prolonged pressure to the fetal scalp causes serosanguinous fluid to leak from the subcutaneous tissue into the area above the periosteum between the scalp and the lining of the periosteum with resultant edema and/or bruising. This location results in a collection of fluid that crosses over the cranial sutures (Fig. 21.1) [1, 2]. • Royal College of Obstetricians and Gynaecologists RCOG. Caput succedaneum. • Mangurten HH. Birth injuries. In: Martin RJ, Fanaroff AA, Walsh MC, editors. Neonatal-perinatal medicine: diseases of the fetus and infant. 8th ed. Philadelphia: Mosby; 2006. p. 531–5. • Fraser D, Cooper M. Caput succedaneum. In: Myles textbook for midwives. Amsterdam: Elsevier Health Sciences; 2009. p. 860. • Stoll, BJ, Kliegman, RM. Nervous System Disorders. In: Behrman, RE, Kliegman, RM, Jenson, HB. Nelson Textbook of Pediatrics. 17th ed., Philadelphia, PA: Saunders, 2004. p. 562. • Bats A, Senat M, Mohlo M, Ville Y. Discovery of caput succedaneum after premature rupture of the membranes at 28 weeks gestation. J Gynecol Obstet Biol Reprod (Paris). 2003;32:179–82. • Winter T 3rd, Mack L, Cyr D. Prenatal sonographic diagnosis of scalp edema/cephalhematoma mimicking an encephalocele...

Understanding Birth Injuries to the Head While cephalohematoma and caput succedaneum are both birth injuries to a baby’s head, each has its own set of causes and symptoms. In most cases, cephalohematoma and caput succedaneum are not severe or life-threatening, however, there are some risks and complications you should know. What is Cephalohematoma? Cephalohematoma is an accumulation of blood under the scalp. Blood vessels can be damaged during the birth process as a result of trauma. Specifically relating to cephalohematoma, small blood vessels crossing the periosteum (the membrane that covers the skull bones) are ruptured, and blood and fluid collect between the skull and periosteum. The development of cephalohematoma is slow and may not develop for hours or days after birth. Although rare, cephalohematoma can cause the following problems for the baby: • Linear skull fractures (typically heals on its own) • Calcification of the cephalohematoma (bone deposits that form and harden around the blood pool can cause skull deformities) • Infections (occurs when the fluid and blood from the cephalohematoma become infected) • Anemia (having cephalohematoma increases the risk) Causes of Cephalohematoma The rupturing of blood vessels is due to pressure on the baby’s head during the birthing process. The following factors can increase pressure on a baby’s head and cause cephalohematoma: • Delivery by use of • Delivery by use of • Prolonged labor • Fetal macrosomia (a baby who is much...