Kefalogematoma in newborns: consequences, treatment, removal
Unfortunately, natural births do not always flow perfectly.So, when passing a baby through the birth canal, it can cause all kinds of injuries.According to statistics, birth injuries are observed in about 10% of newborns.A variety of birth trauma is a cephalohematoma.Table of Contents: Causes of Cephalomatoma Symptoms Effects of Cephalomatoma and Prognosis Treatment of Cephalomatome
A cephalohematoma is a collection of blood between the bone of the skull and the periosteum that has peeled off from it.The tumor is always limited within one skull bone and does not extend beyond its boundaries .This is due to the fact that along the line of cranial sutures the periosteum is firmly fused with the bones.Therefore, blood accumulates within the same bone.However, if the birth trauma is accompanied by fractures of several bones of the skull, then the cephalohematoma may be located above several bones.Kefalogematoma is diagnosed in 0.2-0.3% of newborns.Most often, the tumor is localized in the parietal, less often occipital and frontal bones.
How does a cephalohematoma arise?During the passage of the baby's head through the birth canal, the skin with the periosteum is displaced.As a result, blood vessels are bursting.Due to the lack of blood coagulation factors in a newborn, the blood remains liquid for a long time and does not coagulate.
The following factors contribute to the formation of birth trauma:
- Large fruit weight;
- Wrong position of the fetus;
- Narrow pelvis in the parturient woman;
- Vacuum extraction of fetus, use of obstetric forceps;
- Weakness of labor.
The cephalohematoma becomes noticeable usually on the second-third day of the baby's life, when the birth canal falls.Externally, the cephalohematoma looks like a subcutaneous protrusion with sharp edges along the edge of the skull bone, in other words, a "lump" on the head.To the touch the tumor is elastic, sometimes it is possible to probe the movement of the liquid.The skin above the tumor is unchanged, of a normal color, and sometimes spotted hemorrhages can be seen.Kefalogomatomu on the periphery delimits a dense roller.
The cephalohematoma may contain 5-150 ml of blood. Depending on the size of the subperiosteal hemorrhage, three degrees of cephalothorematology are distinguished:
- I degree - hemorrhage diameter up to 4 cm;
- ІІ degree - diameter from 4 to 8 cm;
- ІІІ degree - more than 8 cm in diameter.
Please note! Kefalogem should be differentiated with a generic tumor.The latter arises because the bones of the skull of the fetus, during labor, are pressed against the mother's pelvis, as a result of which the outflow of blood from this part of the body is disturbed.In this case, the vessels remain intact and are not torn.In fact, a generic tumor is nothing more than a swelling of the soft tissues of the head.
The generic tumor, unlike the cephalohematoma, is not limited to the bones of the skull and can occupy a large portion of the head.In addition, it has a jelly-like consistency and resolves in the first day of the baby's life.
Consequences of cephalohematemia and prognosis
Often, cephalohematomas dissolve by themselves.So, with a small hemorrhage, the tumor begins to decrease within a week and disappears completely within three to eight weeks. With a significant hemorrhage, the resorption process can last for two to three months.
In most cases, the cephalohematoma proceeds favorably. However, with the cephalohematoma, the following complications may occur:
- Anemia - develops with severe blood loss;
- Jaundice - with the breakdown of hemoglobin with the formation of bilirubin;
- Suppuration - when bacteria get into the tumor through the damaged skin;
- Ossification( ossification) of cephalohematoma - due to the deposition of calcium salts in the cavity.
Parents should not worry about how the cephalohematoma will affect the neurodevelopment of the child .The fact is that the blood with the cephalohematoma accumulates over the bone and does not squeeze the brain.Therefore, there will be no neurological disturbances.This is possible only in the case when the cephalohematoma is additionally accompanied by fractures of the bones and brain damage.
Treatment of cephalothromatosis
With minor cephalohematomas, no special therapy is required, it is enough to provide peace to the baby .Parents need to save the child from possible damage to the skin in the area of the cephalohematoma, and also not to squeeze the head with tight caps.
With small cephalohematomas, newborns undergo medical therapy .The neonatologist appoints calcium gluconate and vitamin K to enhance blood clotting.
For large cephalomatoms, surgical treatment is used - puncturing the tumor.Before puncturing the cephalohematoma, the necessary area of the skin is shaved and disinfected.Then the puncture needle is injected into the cephalogamate and the blood is evacuated from the tumor.Pressing on the hematoma from the periphery to the center, the surgeon achieves complete emptying.After aspiration of blood, an aseptic pressure bandage is applied to the skin for two to three hours.Manipulation takes about ten minutes and is well tolerated by children.
If the skin is damaged in the area of the cephalohematoma, surgical treatment is resorted to in the coming days because of the high risk of infection.In case of detection of pus when puncturing the cephalohematoma, its cavity is opened and drained, and then antibiotics are prescribed.
Ossification of the cephalohematoma leads to permanent deformation of the skull.And to get rid of this defect it is possible only by surgical removal of the ossified parts of the tumor, after which the edges of the wound are sutured.
Grigorova Valeria, medical reviewer