Kefalogematoma in newborns on the head: reasons for how to treat, prevention

Kefalogematoma in a newborn is the accumulation of blood on the head within the bone, which occurs in the child due to the peculiarities of the process of birth. This is a very common pathology to date due to the increase in the number of complicated births. The peculiarity of cephalogematoma is an individual approach to treatment, which every mother should know.

[1], [2], [3]

Epidemiology

Statistics on the birth of children with cephalohematomas suggests that for 200 newborn babies one has this problem. In 45% of cases, the cephalohematoma is combined with a generic tumor. In healthy full-term babies with a cephalohematoma more than 67% of cases of pathological births. With regard to preterm, about 15% of these newborns have a cephalogam, irrespective of the course of the delivery itself.

[4], [5], [6], [7]

Causes of the cephalohematoma in a newborn

To understand the causes of cephalohematemia, you need to know what is in this concept. This is the accumulation of blood, which eventually thickens, within the same bone under the periosteum. It is very important that blood accumulates precisely within the bone, and does not spread further.

What are the causes of cephalohematemia on the head of a newborn? The main cause of the formation of any hematoma is external impact in the form of impact or physical influence. Therefore, the cause of the formation of the cephalohematoma is most often the complicated delivery. But here it is not necessary to talk about the intervention of doctors during childbirth, but rather vice versa - the lack of active tactics of labor can lead not only to the formation of cephalohematemata, but also other complications.

The cause of the formation of a cephalohematoma can be considered a pathology of the structure of the pelvis, in which there may be injuries or wrong turns of the child. Often hematomas are observed when using obstetric forceps or simple extraction of the fetus.

Even without the absence of an obvious cause, there may be observed cephalohematemata due to the simple weakness of the vascular wall. Most often this pathology occurs in premature infants. This is due to the fact that the structure of the bone has its own characteristics - a strongly developed germinative matrix, which is very easily traumatized. Therefore, even with normal childbirth, a premature baby may have a cephalohematoma.

[8], [9]

Risk factors

Based on these reasons, it is necessary to identify risk factors for the development of cephalohematemata. These include pathological pregnancy, complicated labor, intervention in childbirth, and the birth of a premature baby. All this is a potential threat to the development of such a pathology.

[10], [11]

Pathogenesis

The pathogenesis of the formation of the cephalohematoma consists in the rupture of the blood vessels that supply the bone, and the blood can flow freely under the periosteum. This is accompanied by the formation of a hematoma within the bone where the vascular rupture occurred. Such a rupture of the vessels can be with prolonged compression of the tissues of the head, for example, with weakness of labor activity, when the baby's head is for a long time in the same plane of the pelvis. This disrupts the normal outflow of blood and, with further movement of the fetus, a hemorrhage may occur under the periosteum.

[12],

Symptoms of the cephalohematoma in a newborn

The first signs of cephalohematemia appear after birth, and they are very objective. Even a mother can see the asymmetry of the child's head because of a tumor of different sizes. This asymmetry may be different and depends on the location of the hemorrhage. Most often, you can see the mullet of the left or right parietal region in the newborn, sometimes occipital, since these places are most amenable to compression at birth. Symptoms of cephalohematoma are characterized by the presence of a tumor of clear size, corresponding to the size of the bone. Such a tumor slightly fluctuates when pressed, it can be blue. It does not affect the general condition of the child and can be easily tolerated by the child. The only unpleasant symptom is the asymmetry of the child's head.

[13], [14]

Stages

Stages of development of cephalohematoma do not differ from those of hematomas located elsewhere. Naturally, the duration of each stage depends on the amount of blood that is in the tissues. At the beginning of the development of the cephalohematoma is the accumulation of liquid blood, which resulted in the surrounding tissues. After a few hours, the blood begins to thicken gradually. Then the symptom of "fluctuations" will no longer be. Over time, such blood gradually dissolves and the hematoma passes. How does the cephalohematoma dissolve in newborns? The process starts from the center in such a way that a small roller of blood is formed along the edges, which has not yet fully lysed. In this case, the blood dissolves into its constituents and bilirubin is formed, which can cause the child to have transitory jaundice. Therefore, one of the symptoms of cephalohematemia in a newborn can be the appearance of jaundice at the time of resorption. As a rule, it should not exceed physiological boundaries, but if the cephalohematoma is very large, then you need to closely monitor the condition of the child.

[15],

Complications and consequences

Is neonatal nephritis dangerous? It's hard to say unequivocally. But the symptoms of a small cephalohematoma do not bring any harm to the child, do not disturb the baby's nutrition, it does not hurt, the body temperature does not rise. But if the hematomas are of considerable size, then there is a risk of complications. The most frequent complications can develop with significant hematomas, when the volume of blood is impressive. In this case, the newborn can develop anemia with further severe jaundice.

One of the consequences can also be considered ossification of cephalohematoma in newborns. This can happen when not all of the blood is completely absorbed and a bone ridge is formed around the edges. It can be small in size and can cause no fear. The only thing, there can be a cosmetic defect in boys, and that more often it passes with the growth of the bones of the skull. One of the frequent complications can also be infection with the development of septic conditions. It can be at an operative intervention in the form of a puncture. Therefore, the consequences and complications of cephalohematoma directly depend on its size and tactics of treatment.

[16]

Diagnostics of the cephalohematoma in a newborn

Diagnosis of cephalohematoma in newborns has no difficulties, because visually this is a very clear picture and this is one of the few diagnoses that can be seen. The main role here belongs to differential diagnosis. But despite this, with the large size of the cephalohematoma, there is a need to control the child's condition. With severe jaundice, tests should be performed to determine the level of bilirubin in the blood.

Instrumental diagnostics should be performed to avoid complications and clarify the diagnosis. Ultrasound diagnosis allows you to determine the location of the hematoma, as well as accurately determine the amount of blood. In dynamics, you can see how the resorption occurs and the need for active treatment of pathology.

If the child is premature and has a cephalohematoma, it is recommended that an ultrasonography of the brain is also performed to assess the state of the nervous system.

[17],

Differential diagnosis

Kefalogematoma refers to the extracranial hemorrhages, therefore it is necessary to conduct differential diagnosis with other similar pathologies - subaponeurotic hematoma and the birth canal.

Subaponeurotic hematoma is the accumulation of blood in the space between the periosteum and the aponeurosis of the tendon helmet. Such a tumor is huge and rhapsologa from eyebrows to the back of the neck. And the main differential feature of the cephalohematoma is its location within the same bone.

Generic swelling is an edema of the soft tissues of the skull without hemorrhage. This occurs when the fetus is standing for a long time in the same plane, which breaks the outflow of venous blood from the head and causes such swelling. Therefore, the distinctive feature of the birth canal is its conformity to the presentation of the child. It passes faster than the cephalothorem and there is no fluctuation.

[18], [19]

Treatment of the cephalohematoma in a newborn

Approaches to the treatment of cephalohematemata are very different and for today there is no single tactic for treating pathology. Different clinics have different experiences and their approach to this problem, so treatment may differ. And to say that one tactic is better than another, since different cases differ from each other.

Conservative treatment of cephalohematoma provides only observation of the tumor, regardless of its size. This is because the additional external intervention always increases the risk of external infection. Therefore, some doctors observe the hematoma until it is completely resorbed. At the same time, the child's condition, tests, jaundice and other manifestations are monitored.

There is a tactic of treatment, in which only a small hematoma is to be monitored, and if its dimensions are significant, the rate of self-resolution is very small. Therefore, they offer surgical treatment. In this case, the puncture of the cephalohematoma in the newborn is most often used. This allows you to suck up more blood, and what remains independently can be resolved. In doing so, all conditions should be used to minimize external infection.

The removal of the cephalohematoma in newborns can be used for the accumulation of large amounts of blood, which has already partially curdled and can not self-resolve. Sometimes there is a very large clot that can not be cured in any way, except for active surgical intervention.

Medications in the treatment of cephalohematemata do not have an evidence base for their effectiveness. It can be said that the very organism of a child can better and quickly cope with a cephalohematoma of any size than external factors. But nevertheless, use different ointments, creams, gels to improve blood circulation and more active resorption of the hematoma. Troxevasin in neonatal nephropathy is used very often, as a means for topical application. It improves local blood circulation, lymph drainage, which speeds up the process of resorption of tumor remnants.

But in any case, in choosing the tactics of treating cephalomatoma, the mother should consult the doctor. It is necessary to clarify all the treatment options that the doctor suggests in this case and talk about the possible consequences. All the same parents decide, but they should know about all the nuances and possibilities of treating such a condition in a child.

Prevention

Prevention of cephalohematoma is a difficult task, because it is very difficult to predict such a pathology. But considering that this occurs in mothers with complicated pregnancy and childbirth, as well as in premature infants, the main method of prevention can be considered a normal pregnancy. Mom and Dad must take care of their health, remembering the health of their future children.

[20], [21], [22], [23], [24]

Forecast

The prognosis of favorable resolution of the cephalohematoma is positive, since pathology does not often have complications.

Kefalogematoma in a newborn is not necessarily associated with improperly performed births by a doctor. This condition can develop in a healthy baby, the poet does not need to panic. Expectant tactics with the minimization of external interventions are considered to be the most acceptable method for treating cephalohematoma.

[25], [26]