Infant cephalohematoma is a medical condition that occurs in 1-2 percent of all live births. It is more likely to happen if birth-assisting tools were used during delivery, such as forceps or vacuum extraction. If forceps or a vacuum was used, the rate of cephalohematoma increases to 3-4 percent.
Although it is considered a minor injury that usually heals without any major medical problems, there are certain factors related to cephalohematoma that may lead to additional complications.
What is Infant Cephalohematoma?
Cephalohematoma is a traumatic subperiosteal hematoma that occurs underneath the skin, above the periosteum of the infant’s skull. The periosteum is a layer of connective tissue that surrounds skull bone.
Cephalohematoma does not pose any risk to brain cells, but it causes unnecessary pooling of blood from damaged blood vessels between the skull and inner layers of the skin. Cephalohematomas are not usually evident at birth, but develop during the hours and days following birth due to the gradual nature of the blood accumulation.
What Causes Cephalohematoma?
Cephalohematoma generally occurs during labor and delivery. It often occurs as a result of difficult or prolonged labor. The use of forceps during delivery has been linked with a heightened risk of cephalohematoma. This is especially true if excessive force was applied to the infant’s head during delivery.
According to UBM Medica Network (UBM), cephalohematoma is most often caused by birth injuries. In some instances, there is clear evidence of birth trauma. In others, there is no indication of any sort of trauma other than the injury itself.
Can Cephalohematoma be Prevented?
The best way to prevent cephalohematoma is to recognize possible risk factors and adjust prenatal care accordingly. Some of the primary risk factors for cephalohematoma include:
- The infant’s head is larger than the mother’s pelvic area
- Weak or ineffective uterine contractions
- Difficult, prolonged labor
- Abnormal fetal presentation
What are the Symptoms of Infant Cephalohematoma?
Cephalohematoma is mostly internal, so it’s not as easy to see as a laceration, and infants may not react with obvious behavioral symptoms. The most common symptom of cephalohematoma is an unnatural bulge appearing on the infant’s head. There will be no cut or bruise, but you may notice the bulge gets harder over time.
Less common, but relevant symptoms that a doctor can diagnose include:
If you find an unnatural bulge on the baby’s head, it should be checked out by your physician immediately.
The first and most important step is to get your baby examined by a doctor. Your doctor can guide you on the best way to handle your child’s cephalohematoma. Some cases require treatment, and others resolve on their own over time.
In most instances infants will heal on their own within three months. However, hardening of the hematoma can occur causing significant deformities of the skull. Other complications include infection that can lead to sepsis or osteomyelitis. These complications are very rare, but you should be aware that they can happen.
In cases where the blood build-up is so excessive that it lowers the baby’s red blood cell count, a blood transfusion may become necessary.
Infants with cephalohematoma are also at a heightened risk for developing jaundice, because as the blood cells break down the levels of bilirubin increase. In these instances, and if the bilirubin is excessively high, treatment may include phototherapy.
Although most infants with cephalohematoma will heal on their own, it’s important to monitor and observe your child. Keep a close eye on any additional bulging or signs of jaundice. Also monitor for any behavioral changes such as increased sleepiness, increased crying, change in the type of cry, refusal to eat or any other signs of pain or infection.
As long as your child is healing, the prognosis for cephalohematoma is generally very good. The key is keeping your healthcare provider informed of any changes in your child’s health or behavior.
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