A cephalhematoma is a hemorrhage (a collection of blood) found between the skull and periosteum of a newborn baby as a result of birth trauma. The periosteum is a membrane lining the outer surface of all bones (except at the joints of long bones). During vaginal delivery, the mother’s cervix grips the scalp of the child causing tearing of tiny vessels that nourish the periosteum from the bone side leading to hemorrhaging under the periosteum. This hemorrhage results in a squishy swelling with distinct borders. The cephalhematoma may begin to form during labor, but it can also enlarge slowly in the few days after birth.
A cephalhematoma is often confused with a caput succedaneum, or swelling in the scalp. A caput succedaneum can coexist with a cephalhematoma, but a caput succedaneum is more generalized and ephemeral disappearing in a day or two.
A cephalhematoma is also similar to a subgaleal hematoma (hemorrhage). A subgaleal hematoma is blood above the periosteum between the scalp while a cephalhematoma is blood underneath the periosteum.
Influence of Delivery Instruments
A cephalhematoma is almost always a complication of child birth caused by use of an instrument to aid vaginal delivery. Delivery forceps have commonly been associated with cranial birth trauma and injury, but in more recent years vacuum extraction (aided by a device such as a ventouse) has become the preferred instrument to aid vaginal delivery.
A ventouse is a vacuum device that has a suction cup that is placed on the head of a baby providing traction so that the baby’s head can be born. After the head is present, the ventouse device is detached and the mother continues delivery. The suction provided by use of a ventouse can leave the baby with a chignon, or temporary swelling that takes anywhere from two hours to two weeks to heal. Use of the ventouse can also lead to caput succedaneum, a subgaleal hematoma, or cephalhematoma.
Cephalhematoma Physical Effects
In most instances, the blood found in the cephalhematoma breaks down and components are reabsorbed in the body. Calcium will deposit in the area of the ameliorating cephalhematoma leading to a hard distinct ridge around the edge of the swelling (the center of the swelling will feel like a soft balloon). The cephalhematoma will later become hard and calcified. The calcification will eventually also be reabsorbed into the body and disappears.
While an uncomplicated cephalhematoma will likely leave no physical trace, problems do arise. Cephalhematoma can result in a newborn child developing jaundice, hypotension, anemia, meningitis, or osteomyelitis. A cephalhematoma can also be accompanied by a skull fracture or brain trauma and injury. While uncommon, a cephalhematoma with an accompanying skull fracture can lead to a leptomeningeal cyst. Severe cephalhematoma can become infected, take many months to resolve, or require surgical drainage.
Today it is more common for child births to be delivered by cesarean section when labor complications arise. While natural vaginal birth requires less healing time than a cesarean section, considering the potential for birth trauma or injuries such as cephalhematoma, cesarean section birthing methods should be considered.
Cephalhematoma Legal Options
If you have delivered a baby and your child has suffered unnecessary injury or trauma such as cephalhematoma as part of the vaginal birthing process, you might want to seek professional legal advice concerning your options. With alternative birthing methods such as cesarean sections, birth injuries or trauma related to vaginal birthing methods (such as cephalhematoma) should be minimized.
The law firm of Seeger Weiss LLP has a team of qualified medical malpractice attorneys and lawyers who are experienced in birth injuries and trauma when health professionals deviate from acceptable standards of practice in providing medical care. If you believe that your child’s case of cephalhematoma is related to a deviation in acceptable standards of medical practice, please contact Seeger Weiss for a free case evaluation, or call 888-584-0411.