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Cephalohematoma vs. Caput Succedaneum

by The Beasley Firm  |  October 26, 2020  |  

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 forceps
  • Delivery by use of vacuum extraction
  • Prolonged labor
  • Fetal macrosomia (a baby who is much larger than average)
  • Weak uterine contractions
  • Abnormal fetal position
  • Multiple fetuses

Symptoms of Cephalohematoma

Cephalohematoma doesn’t typically come with obvious symptoms, and it may be necessary to consider cephalohematoma if the baby has:

  • Bruising on the newborn baby’s skull
  • Anemia or low red blood cell counts
  • Jaundice (yellowing of the skin)
  • An infection

What is Caput Succedaneum?

Caput succedaneum is subcutaneous (under the skin) swelling or edema of the scalp following vaginal delivery. Caput succedaneum is not uncommon and can occur through normal pressure and compression of the baby’s head as it passes through the birth canal.

While rare, caput succedaneum could cause the following problems for a baby:

  • Bruising of the skin
  • Jaundice
  • Skin Necrosis (death of cells)
  • Scarring
  • Alopecia (loss of hair)
  • Systemic infections (infections that spread through the body’s system)

Causes of Caput Succedaneum

Caput Succedaneum is caused by prolonged pressure from the cervix or vaginal wall on the baby’s head. The following are other factors that can increase pressure on a baby’s head and cause caput succedaneum:

  • Delivery by use of forceps
  • Delivery by use of vacuum extraction
  • Prolonged labor
  • Rupture of membranes
  • Low amniotic fluid levels
  • Sporadic contractions (also known as Braxton-Hicks contractions)
  • Abnormal fetal position

Symptoms of Caput Succedaneum

Caput succedaneum is a relatively common condition that usually occurs from pressure during the labor and delivery process. Swelling associated with caput succedaneum may present down both sides of an infant’s head. Caput succedaneum is generally not painful but can result in severe complications in rare cases. 

How to identify caput succedaneum:

  • Puffiness or swelling of the scalp
  • Bruising of the scalp (in some cases, facial bruising may be present)
  • Bumps on the scalp
  • Hair loss
  • Scarring

In some instances, caput succedaneum may result in jaundice. Jaundice should be monitored closely by a medical professional. Caput succedaneum is often diagnosed within the first few hours after birth and resolves within a few days. 

After delivery, a baby with caput succedaneum may have a cone-like appearance, or the scalp may be spongy. In some cases, a doctor may be able to detect it early through ultrasound.

Is Caput Succedaneum or Cephalohematoma Worse?

Caput succedaneum and cephalohematoma are often confused since they are both injuries that can occur at birth to an infant’s head and have similar causes. While both conditions can cause significant health problems, serious side effects are rare. 

Caput succedaneum and cephalohematoma are characterized by swelling in a baby’s head and are usually diagnosed shortly after birth. Both conditions are caused by pressure exerted during the labor and delivery process. Caput succedaneum refers to the swelling or edema of a baby’s scalp; cephalohematoma occurs when the blood vessels are damaged, resulting in bleeding under the scalp.

There are complications related to both conditions, including jaundice and infection, but serious side effects may be more common with cephalohematoma compared to caput succedaneum.

Caput Succedaneum and Cephalohematoma vs. Subgaleal Hemorrhage

Subgaleal hemorrhage is often misdiagnosed as caput succedaneum or cephalhematoma, but it is significantly more dangerous because of where it is located. A subgaleal hemorrhage occurs between the galea aponeurotica and the periosteum of the skull. The collection of blood can be massive. While rare, they are potentially life-threatening and can prove fatal. 

They are more prevalent with the use of assisted delivery methods, including vacuum extraction and forceps delivery. Subgaleal hemorrhages can result in serious complications, including severe fluid loss, shock, respiratory distress, and organ failure. A prompt, accurate diagnosis of subgaleal hemorrhage can help reduce the risks associated with the condition.

Treatment for Cephalohematoma and Caput Succedaneum

While cephalohematomas and caput succedaneum may look ominous, their treatment is relatively benign. Many times the swelling associated with either condition will subside within a few days. Attempts to reduce swelling by draining the excess fluid or blood may result in infection and other side effects that are more dangerous than the underlying condition. 

If the cephalohematoma or caput succedaneum do not resolve on their own, a physician may recommend further treatments to prevent complications. Depending on the severity of the condition, treatment for complications related to these conditions may include a blood transfusion or antibiotics to treat an infection. 

In cases where jaundice has developed, a doctor may recommend common treatments, including light therapy (phototherapy), intravenous immunoglobulin (IVIg), or an exchange transfusion. 

Did Your Baby Suffer a Birth Injury? We Are Here For You.

If your child sustained a birth injury due to a medical professional’s negligence, you have the right to pursue compensation. Birth injuries can have lifelong, devastating health consequences — and often come with medical bills for treatments and therapies. The Beasley Firm, LLC has secured record-breaking settlements and verdicts on behalf of our clients, and we’re here for you, too.

Protect your child’s future health and well-being. Contact us today for a free consultation.

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