A cephalhematoma is a collection of blood on the head of a newborn baby. It is one of the birth traumas.
What is a cephal hematoma?
A cephalhematoma occurs particularly frequently in forceps deliveries or the use of suction cups. With these methods, special forceps spoons or a suction cup are attached to the child’s skull to make delivery easier. See AbbreviationFinder for abbreviations related to Cephalhematoma.
The cephalhematoma is also known as a head blood tumor or cephalhematoma. It occurs in newborns and shows up as a collection of blood on the baby’s head. In most cases, birth trauma is caused by a birth canal that is too narrow.
While the hematoma appears flaccid at first, it later becomes a bulging lump. However, after a few weeks it goes back on its own. The term kephal comes from the Greek and means “belonging to the head”. A cephalic hematoma occurs during natural childbirth, in which small blood vessels that are located between the periosteum and the outer bone of the skull rupture.
The reason for this is the large shearing forces that act on the baby’s head in the birth canal. In newborns, the skull is still soft so that it can be deformed. A cephalhematoma shows up once or twice in every hundred births. In some cases, there is also an incomplete fracture of the skull bone, which doctors call an infraction.
Causes
A cephalhematoma occurs particularly frequently in forceps deliveries or the use of suction cups. With these methods, special forceps or a suction cup are attached to the child’s skull to make delivery easier. The development of a cephalhematoma is caused by the effects of gravity.
These affect the infant through the narrowness of the birth canal by displacing the soft tissues of the head. This, in turn, can shear the scalp off the bone. Blood vessels located beneath the periosteum rupture, causing bleeding.
In most cases, this is quite strong due to the intensive blood flow to the periosteum. If the space between the bone and the periosteum, which can only be slightly stretched, fills up, the bleeding stops. Eventually, a bulging, elastic swelling develops.
There are some risk factors that bring about a cephalhematoma. It is primarily a forceps birth and a ventouse birth. In some cases, rapid passage of the baby’s head through the mother’s pelvis can also be responsible for the development of the head hematoma.
The same applies to a very narrow birth canal. These factors also produce gravitational forces that give rise to a cephalhematoma. Also one of the risk factors is the parietal position, also called occipital position. This is when the child’s head does not lie in the mother’s pelvic opening, forehead first, as intended. This makes it difficult for the baby to enter the birth canal.
Symptoms, Ailments & Signs
A cephalic hematoma becomes noticeable shortly after the birth process as a bulging, elastic and touch-sensitive tumor. In the first 24 hours after birth, the head hemorrhage enlarges, but then remains limited to the region of the cranial bone. In most cases, the unilateral hematoma forms on a parietal bone (os parietale), which forms the top and back of the skull.
A cephalic hematoma is the size of a hen’s egg and takes on the shape of a hemisphere. The periosteum is very sensitive to pain, so that the baby often behaves restlessly and cries when there are external influences on the head tumor. In rare cases, multiple or very large cephalic hematomas occur.
As a result, there is a risk that anemia (low blood count) will set in as a result of the blood loss. In the worst case, a volume deficiency or even circulatory shock are possible. If the cephalhematoma does not go away on its own, this can indicate blood coagulation disorders.
Diagnosis & course of disease
A cephalhematoma is usually discovered shortly after birth by a midwife or pediatrician. Sometimes the head hemorrhage is also superimposed by a birth swelling of the head, so that the parents only notice it a few days later.
During the examination, the treating pediatrician then asks the parents when they noticed the hematoma, whether the swelling has changed since it was discovered, whether the baby could have sustained a head injury and how the birth of the child went. It is also important whether forceps or a suction cup were used during the birth process.
The next step is the physical examination of the baby. The doctor checks whether the cranial bone sutures are limited or exceeded. He also checks the consistency of the swelling. Any neurological symptoms are also of interest. The child’s eyes and hearing will also be tested.
The course of cephalhematoma is usually positive. Although the head hematoma will increase in size for the first few days, it will go down on its own over the following weeks and months. A dreaded but very rare complication is infection of the hematoma, which can be life-threatening.
Complications
Cephalic hematoma is a very serious disease. If this is not treated, the child can die. In most cases, the cephalhematoma occurs immediately after birth, causing the head to enlarge significantly. This is mostly filled with blood. The heavy filling with blood can lead to various complications in the child’s head.
As a rule, the periosteum is very sensitive, resulting in severe pain. The child cries a lot and is very restless. It is not uncommon for circulatory shock to occur. Sometimes the cephalhematoma can go away on its own. If this is not the case, the affected person usually suffers from blood clotting disorders. These can also restrict further life.
A direct treatment of the cephalhematoma usually does not take place if the blood flows back again. If this is not the case, the blood can also be taken directly from the head to prevent consequential damage. As a rule, the life expectancy of the person affected is not reduced by the cephalhematoma.
When should you go to the doctor?
In most natural births, the cephalhematoma is not a cause for concern. Normally, the consequences of the birth lead to continuous relief of the symptoms within a few days until freedom from symptoms is achieved. Since an intensive examination of the newborn by the obstetrician and paediatrician is carried out immediately after delivery, the parents do not have to take any action in the event of an inpatient birth. In the routine examinations and tests, the child’s state of health is thoroughly examined and changes are observed in detail.
If the condition worsens, medical treatment is initiated immediately. If a home birth takes place, the midwife takes care of the necessary initial care for mother and child. It automatically initiates further steps if the newborn’s health conditions are alarming and consults a doctor in the event of problems.
If there is a sudden birth and no obstetrician is present, a doctor should always be consulted to clarify the state of health of the mother and the child. If the cephalhematoma does not steadily recede within the first few days of life or if the symptoms continue to increase, a doctor’s visit is required as soon as possible. There are serious disorders that can lead to the death of the newborn without medical care.
Treatment & Therapy
A special treatment of the cephalhaematoma is not necessary, since it regresses on its own. A puncture to suck out the blood is not recommended because the risk of infection for the baby is too great. There is a risk of a life-threatening abscess.
The only medical treatment method is the administration of vitamin K, which the body needs to produce proteins, which in turn are important for blood clotting. If there is a head wound at the cephalhematoma, it must be treated sterilely.
Outlook & Forecast
The prognosis of the disease is favorable. Although in severe cases the formation of the hematoma can lead to the death of the newborn, in most situations no medical attention is necessary. The blood congestion that occurs during birth usually drains away gradually within a few days after birth and leads to relief of the symptoms.
The organism therefore completely regulates the formation of the hematoma itself with its own natural possibilities. At the same time, the infant is protected and clinically cared for accordingly. Sufficient rest is important to allow blood circulation to regulate itself. If an alleviation of the symptoms is recognizable, no further measures are necessary.
In some patients, the situation worsens. Medical intervention is required here in order to avert a life-threatening situation. Rarely does an abscess form. This happens in particular if the blood has been sucked out through a puncture. An abscess must be treated immediately by the doctor treating you so that no serious complications occur. Since there is a risk of sepsis in these cases, the newborn can die if the blood poisoning is not treated comprehensively as soon as possible.
Prevention
It is almost impossible to prevent a cephalhematoma. Thus, the head hematoma forms only during the birth process.
Aftercare
In the case of a cephalhematoma, the options for aftercare are relatively severely limited in most cases. The earlier a doctor is contacted, the better the further course of the disease, so that the person concerned should see a doctor at the first signs and symptoms of the disease.
As a rule, no treatment is necessary for a cephalic hematoma, as it should go away on its own. If this is not the case, a doctor should be contacted immediately. The blood should not be sucked out of the cephalhematoma, since in the worst case an abscess can form, which in the worst case can lead to death.
In general, in the case of a cephalhematoma, taking vitamin K has a positive effect on the further course of the disease and can significantly accelerate healing. If the cephalhematoma is on the head, the area must be disinfected in any case. As a rule, no further aftercare measures are necessary.
You can do that yourself
A cephalhematoma does not require any special treatment. It usually regresses on its own after a few days, with no further symptoms to be expected. Parents should ensure that the wound is healing well and that no irritants or pathogens are getting into the injured area.
The bruise can be treated with the help of various home remedies, such as cool pads, aloe vera or a gentle ointment made from calendula or arnica. Alternatively, you can use dressings with onions or parsley – the pediatrician should give his consent before using these remedies. In addition, a cephalhematoma can be alleviated by the administration of vitamin K. Depending on the size of the bruise, the vitamins can be supplied either through diet or through dietary supplements.
Sterile care is indicated for a head wound. There is an increased risk of complications, which is why the treatment must always be monitored by a doctor. After the hematoma has subsided, attention should be paid to abnormal behavior in the infant. If unusual symptoms are noticed, a visit to the pediatrician is recommended.