Cephalohematoma, or CH, is a pooling of blood between the scalp and the skull, predominantly found in babies. The blood collection between the skin and the scalp comes from blood vessels that were damaged during labor and delivery.

The condition is somewhat rare, affecting between 1-2% percent of newborn babies. Although it sounds serious, the condition is not as severely dangerous as it may sound, since the blood is outside the cranium, away from the brain.

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Causes of Cephalohematoma

CH is mainly found in babies due to their soft tissue and delicate blood vessels. The birth injury usually occurs during labor and delivery and occurs more often when a baby’s head is bigger than its mother’s pelvis. In this case, the baby could hit its head on the mother’s pelvis during delivery, causing blood vessels to rupture.

Birth assisting devices can also cause cephalohematoma. In cases where mothers enduring long or difficult labor require forceps or vacuums to assist in the birth, the risk of CH in the infant is higher.

All babies are at risk for cephalohematoma, but certain factors make the injury more likely. Long or complicated deliveries are more likely to result in CH. Prolonged labor is an especially common cause of CH.

Some reasons for prolonged labor include:

  • A baby too large to move through the birth canal with ease
  • A birth canal too small for the baby
  • Weak uterine contractions insufficient for pushing the baby through the birth canal
  • Abnormal position. If the infant is not in a head-down, front-facing position, the delivery becomes complicated
  • Twins or multiple births

Pain medications may also delay labor, as they weaken contractions.

Symptoms of Cephalohematoma

A clear sign of CH is a soft, abnormal lump on the baby’s head. Cuts or bruises on the scalp are uncommon. After a few weeks, the blood under the skin begins to calcify, creating a harder bump. Shortly after, the blood will start to dissipate, and the lump will appear smaller. If the bump starts to take on a concave appearance, do not be concerned. It merely means that the center of the bump healed faster than the edges.

In some cases, a baby may not exhibit any outward symptoms but have internal symptoms instead. Internal symptoms could include anemia, jaundice, or infection.

Diagnosing Cephalohematoma

To determine whether an infant has CH, the doctor will perform a full-body physical. However, most of the time, a bulge on the back of the head is enough indication. As a precaution, your doctor may run additional tests like X-rays, CT scans, MRI scans, or ultrasounds.

Additional scans can help determine whether your baby has any internal symptoms. Even if they do not initially show internal issues, you should still monitor any changes in your baby’s behavior or any new symptoms.

How is Cephalohematoma Treated?

CH is not a serious condition. Most of the time, it disappears on its own. The bump should disappear within a few weeks to a couple of months, though some injuries may take longer to heal.

In rare cases, your doctor may want to siphon out the blood under the scalp. This should only be done when absolutely necessary, as it increases the infant’s risk of developing an infection or an abscess.

Long-term complications from CH are rare, although CH can increase the risk of anemia and jaundice. Due to the build-up of blood CH causes, a low red blood cell count is more probable. In cases where the child develops anemia, a blood transfusion may be necessary to boost red blood cell count.

Jaundice can result from an excess of bilirubin, the yellow pigment found in red blood cells. As the blood between the skull and scalp gets reabsorbed, bilirubin levels rise. If they reach higher than normal levels, your infant may develop jaundice and will exhibit a yellowish tint in the skin and eyes. Jaundice is usually not life-threatening and can be treated using phototherapy or light therapy.

If your child has suffered cephalohematoma and you suspect that a doctor’s negligence played a role, contact an attorney. You may have the right to pursue compensation through a medical malpractice claim.

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