Are Caput Succedaneum or Cephalohematoma Cause for Concern?


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What Head Injuries Are Common After Birth?

Many injuries are possible during birth, and a doctor's negligence can often play a role. Two injuries that can affect the head of a newborn are caput succedaneum and cephalohematoma. While both can happen in the absence of medical malpractice and are generally non-life-threatening injuries, that's not always the case. Occasionally, a doctor's negligence can injure a newborn's head and lead to complications that can have potentially devastating consequences for the infant and their family.

What Is a Caput Succedaneum?

Caput succedaneum is the name for swelling that can occur under a newborn's scalp after birth. This condition is caused by the baby's head pressing against the cervix during labor and can also be caused by vacuum-assisted delivery. It's not uncommon, usually harmless, and complications are rare. A baby's scalp with caput succedaneum feels swollen and soft, and pressing on the scalp may leave an indentation. Swelling often covers a large area of the head, and the fluid under the skin can shift from side to side as the infant's head position is changed. Swelling can be seen immediately after birth, does not worsen, and gradually disappears over the first hours and days of life.

What Is a Cephalohematoma?

Cephalohematoma is bleeding that happens near the skull. It occurs when a baby's head hits the mother's pelvis forcefully and repeatedly during strong contractions and can also be caused by forceps or vacuum-assisted delivery. In most cases, cephalohematomas are harmless in and of themselves, and complications are rare. Cephalohematoma presents as a soft lump under the skin with a well-defined outline. It will typically continue to get bigger for two to three days after birth until the bleeding stops, and most cases resolve without the need for medical intervention. It commonly takes two to six weeks (sometimes up to three months) to heal completely.

What Are the Risk Factors for These Types of Birth Injuries?

Birth assistance tools are a common source of childbirth head trauma leading to both caput succedaneum and cephalohematoma. Birth assistance tools include devices such as forceps and vacuum pump extractors, which help facilitate vaginal deliveries when the baby gets "stuck." These tools work by gripping the baby's head, and they can put enough pressure on the scalp to cause damage and swelling even when used correctly. When used negligently, head trauma becomes much more likely.

Risk factors for head injuries during birth include:

  • male gender (cephalohematoma is twice as common)
  • large birth weight (over 9 lbs)
  • prolonged, difficult labor
  • small pelvis of the mother
  • atypical head position of the infant
  • forceps or vacuum-assisted birth

What Complications Are Possible?

In general, complications are rare, and both conditions tend to resolve on their own without any issues. That said, some of the complications that do occur can be life-threatening, so parents and doctors must know what to look for and how to properly treat any issues that may arise.

Complications of caput succedaneum:

  • Alopecia. Occasionally, pressure on the scalp and the resulting swelling can cause hair loss. Usually, the hair regrows normally, but in rare cases, hair loss can be permanent.
  • Jaundice. If bruises are present, the breakdown of blood cells as the bruise heals can create a chemical called bilirubin. This chemical is difficult for infants to break down and can cause the skin to turn yellow. It's easily treated with light therapy, but it can cause permanent brain damage if left untreated.

Complications of cephalohematoma:

  • Calcification. Sometimes, the blood pooled under the scalp will begin to harden and calcify. In most cases, this will gradually resolve on its own, but it can occasionally continue to grow larger and/or become attached to the skull and may require surgical removal.
  • Anemia. If a lot of bleeding has occurred, an infant may need a blood transfusion.
  • Jaundice. As the blood in a cephalohematoma breaks down and is reabsorbed, jaundice becomes a concern. As there is significantly more blood involved in a cephalohematoma than in a caput succedaneum injury, jaundice (and the possibility of brain damage) is more common.
  • Skull fracture. While not caused by the cephalohematoma, sometimes the bleeding is caused by or hiding an underlying fracture, which means that bleeding may also be occurring in the brain.
  • Infection. This complication can quickly become life-threatening. Infections usually start with fever, redness, and inflammation around the cephalohematoma and can rapidly progress to cellulitis, osteomyelitis, sepsis, or meningitis (infections of the skin, bone, blood, or brain).

Caregivers of any infant with cephalohematoma should be informed to watch for irritability, poor feeding, lethargy, continued growth of the cephalohematoma, reddening around the area, fever, and apparent pain or sensitivity to touch. These symptoms may indicate bleeding in the brain and/or infection, and immediate medical care is essential.

What Can You Do if a Doctor's Negligence Caused Harm?

While these head injuries are typically harmless and go away over time, the complications they can cause are serious. If a doctor's actions caused a head injury that developed complications, or if they failed to treat those complications correctly, then your family may be entitled to compensation for hospital bills, along with any pain and suffering your child and family have endured. Likewise, suppose a doctor attempted to drain blood or fluid from either of these head injuries without a medical reason and it resulted in an infection or abscess. In that case, they should be held accountable for the harm they caused.

Why Choose Ross Feller Casey?

When a child is needlessly injured or dies as a result of a medical professional's action (or inaction), the legal team at Ross Feller Casey is here for you. Our doctor-lawyers understand that many birth injuries are unavoidable. Still, when a doctor fails to follow best practices and causes harm, we will do everything in our power to hold them accountable and get you the compensation you deserve.

Consultations are free, and you only pay if we win your case. We've helped our clients recover more than $3 billion, so we know what it takes to get results. Contact us today, and let us help you get the justice that your family deserves.

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