Cefalohematoma in newborns: effects,treatment, causes, puncture

Update: December 2018

Although childbirth is a natural process, they can
cause injury to the mother and baby. As is known, the birth canal
surrounded by the walls of the large and small pelvis. They are much stronger
than the head of the newborn, consisting of elastic cartilage and bones
the skull. If the mother’s pelvis is so narrow that the baby cannot
to go through it – the childbirth “stops.” Doctors perform
cesarean section.

In the event that a newborn passes through the birth canal, but
pelvic bones render him considerable resistance, perhaps
development of cefalohematoma.

What is cefalohematoma

This accumulation of blood between the bone of the skull and the periosteum is thin.
connective tissue plate. It attaches exactly on
contour bones: occipital, frontal, temporal, parietal. therefore
cefalohematoma cannot spread beyond one of
of them.

There are several such hemorrhages on the head of the newborn.
In addition, each of them will occupy space only above
a certain bone. Explain by example. A child may have 2
cephalohematomas – one above the occipital, the second above the temporal bone.
Two such hemorrhages can not be only above the occipital bone.
If you can feel / see such a picture, be sure –
it is not a cephalohematoma.

Causes of cefalohematoma

Currently, there are three main groups of reasons for this.
birth injury:

  • Narrow pelvis women in childbirth with natural childbirth (without cesarean
    section);
  • Using a vacuum extractor and obstetric forceps;
  • Diseases of the newborn that lead to increased
    bleeding.

Each of these situations must be considered separately, since
they have their own characteristics of treatment and prevention.

Narrow pelvis of the woman in labor

When registering pregnant women, in female consultation
be sure to measure the size of the pelvis of women special
instrument – tazomer. These results are entered into the exchange card and
transfer to obstetricians-gynecologists maternity hospital.

If during the study found a narrowing of the size of the pelvis,
determine how it is expressed. Depending on this doctor
concludes how to give better food – through a caesarean or
natural birth canal. With your decision, an obstetrician is required
will introduce the future mother, who will give prior consent / refusal
from the procedure. Incorrect tactics may result in
appearance of cephalohematoma.

Use of extractors

With the weakness of labor when the newborn
�”Delayed” in the birth canal, it may be necessary to
the use of mechanical tools for the extraction of pebenka. If a
conventional therapy is ineffective and there are no contraindications to the procedure,
imposition of a vacuum extractor or obstetric forceps is possible.
A typical complication of such fetal extraction is cephalhematoma.

Diseases of the newborn with increased bleeding

If a роды прошли без патологии, при нормальных размерах таза и
without imposing extractors, but cephalhematoma is formed in the child
– this is an occasion to think about this reason. Of course, that
hemorrhage under the periosteum may occur without any
pathological causes. However, it is important to keep in mind the possibility
the presence of a newborn: hemophilia A, B; von Willebrand disease
or another disease with impaired blood coagulation.

An additional sign that may indicate
the presence of this reason – the increase in cefalohematoma on the head
newborn in the first day after birth.

Signs of cephalhematoma

кефалогематома у новорожденныхExternally, it looks like
ordinary bump. Hemorrhages can have different sizes and volume –
from 10 ml to 150 ml. The largest cefalohematomas can completely
repeat the contour of the bone. For example, over the temporal bone can
detect a triangular protrusion, above the parietal –
rectangular, etc.

By probing the hematoma, the following characteristics can be found.
signs:

  • In the center it is soft, elastic, easy to finger
    pressing;
  • A roller is defined at the edges of the cephalohematoma – this is a compacted
    periosteum;
  • Most often, probing is quite painful. therefore
    pressing the area hard with hemorrhage can lead to crying and
    �“Protective reflex” (trying to push the source away
    pain).

How to distinguish a generic tumor from cephalhematoma

These are two different complications of labor, which should be distinguished.
from each other. Generic tumor – the usual edema of the subcutaneous tissue
child, which may occur during the passage of his generic
ways. As a rule, the treatment of the newborn is not required and edema.
self-disappears within 2-3 days. What
Cephalohematoma was discussed above.

You can distinguish complications by the following features:

Sign of Cefalohematoma Generic tumor
Location Repeats the contour of the bone or is limited to its area. Generic tumor может занимать область нескольких костей
Consistency Soft and elastic �”Testavataya”
Presence of boundaries Cefaloghematoma is limited by a dense roller – thickening
periosteum
There is no clear boundary between the birth tumor
Duration process From a week to several months Up to 2-3 days

Treatment of cefalohematoma

Unfortunately, there is no consensus on this issue among doctors.
Treatment of cefalohematoma у новорожденного с одинаковым успехом можно
perform two methods – conservative and operational.

Conservative

The method is used for small hemorrhages – up to 50-70 ml. AT
In this case, wait until cephalhematoma resolves.
on their own. AT среднем, процесс занимает 1,5-2 месяца. Speed ​​up
resorption is possible with the help of Troxerutin (synonymous with Troxevasin) in
ointment form – the drug increases the tone of blood vessels and prevents
�”Leakage” of plasma and cells through their walls. Medicine is allowed
apply to children from infancy, causing 2% gel on the area
гематомы  не более 2-х раз в день и втирая его в кожу
heads.

In some patients, this method is ineffective, due to the peculiarities of their
organism – instead of spontaneous resorption through some
time comes organization hematoma (growth of connective
fabrics).

Surgical

Puncture of cefalohematoma in newborns is the only
operational treatment method. Optimal use no later than
7 days from the appearance of hemorrhage. After the first week it is possible
the beginning of the growth of connective tissue, so the execution of puncture
considered inappropriate.

As a rule, the surgical method is used only for large
cephalohematomas – more than 100 ml in volume. Puncture is performed for
5-10 minutes, after which the child with his mother goes home.
The needle point is smeared with an antiseptic solution and applied
bandage for several days.

Treatment of cefalohematoma при болезнях крови

If a родители или их родственники страдали от таких заболеваний
крови, как гемофилия типов А и Б, von Willebrand disease или
another blood coagulation disorder, you need to check the child
for the presence of these pathologies. It should be noted that hemophilia A and B
mostly boys are sick. Number of girls with these
pathologies are extremely few. Заболевание ATиллебранда не зависит от
floor.

When one of these diseases is detected, a child is born
prescribing substitution therapy with substances that are not enough for
blood coagulation. With regular treatment and adequate control
disease, the quality of life of these children is maintained at the level of their
healthy peers.

Kefaloghematoma Suppuration

For abrasions, scratches or any other damage to the area.
Cephalohematomas may penetrate bacteria and develop purulent
process. In newborns, the body is very sensitive to any
infection, even local. It should be noted that this is a complication
occurs extremely rarely.

Hematoma suppuration is accompanied by:

  • Redness of the skin over the area of ​​hemorrhage;
  • Seal the specified area;
  • ATялостью ребенка – он может полностью прекращать плакать или
    tire quickly after the start of a scream;
  • The child may refuse to breast, due to intoxication and
    loss of appetite;
  • Повышением температуры тела до 38-39оС.

Detection of one of these symptoms is a reason to turn to
to the doctor. They treat the suppurative cephaloma as an abscess:

  1. ATыполняют пункцию и «отсасывают» содержимое полости;
  2. AT рану могут установить дренаж – резиновую трубочку, которая
    allows secretion of secreted fluid from the wound;
  3. The doctor may prescribe adequate doses of antibiotics. More often
    used josamycin because its safety for newborns
    confirmed by the international association FDA.

Не следует затягивать с лечением гнойного process у младенца,
так как это опасно генерализацией process и привести к трагическим
the consequences.

Care for baby with cefalohematoma

Cefalohematoma может причинять определенный дискомфорт младенцу,
therefore, care for him has its own characteristics. Most of them
aimed at reducing the amount of pain in a child,
предотвращение осложнений и создания удобного положения для heads.
The following recommendations should be followed:

  • Observe doctor’s prescriptions and do not use additional
    �”Blood” means, including folk. Child’s body
    very sensitive to all chemically active substances, therefore
    It is important not to overdo the treatment. If a доктор прописал только
    Troxerutin, should not independently supplement therapy. It may
    lead to increased bleeding and other adverse
    the consequences;
  • Keep the baby’s head from any damage. Blunt blow at
    падении младенца может привести к разрыву periosteum, так как она
    already tense due to the presence of cephalhematoma. Damage area
    hemorrhages with a sharp object (scratch, scraping, puncture, etc.)
    can lead to microbial invasion and hematoma suppuration;
  • Do not tightly tie hats, caps and render
    pressure on the area of ​​hemorrhage. ATсе это приведет к усилению
    pain in a child;
  • Monitor the change in hematoma size. If a вы отмечаете рост
    кефалогематомы – это повод срочно обратиться к to the doctor. Increase
    sizing indicates continued bleeding or withdrawal
    plasma from the walls of blood vessels;
  • To give the child a head with cephalhematoma handy
    provisions, there are special gel pads. They are uniform
    distribute pressure between different parts of the head and reduce
    discomfort baby.

By following these simple rules, you reduce the likelihood of development
complications of cephalohematoma and unpleasant sensations
baby

Consequences of cefalohematoma

How dangerous is this hemorrhage? More often ничем. AT подавляющем
most cases, the effects of newborn cephalhematoma
absent and in older age it is impossible to say that this
осложнение родов было в прошлом у baby

Since blood accumulates over the bones of the child’s skull, it does not
can damage his brain and other parts of the nervous system.
Suppurative hematoma, with timely and adequate treatment,
also will not affect the state of the body.

The only consequence of cefalohematoma in the future can be
discover when it is organized. If a кровь не рассасывается, а
replaced by connective tissue, bone deformity occurs.
However, with a small amount of hemorrhage (up to 70 ml), detect
This defect in the form of a small protrusion will be extremely difficult in
older age. Of great cosmetic value, as a rule, he
does not have.

We emphasize again, mental retardation, violations
speech, paralysis and other neurological diseases after
Cephalohematoma does not happen.

Cefalohematoma – это только скопление крови, которое находится
above the bone. The brain is located inside the skull. Blood clot
cannot deform the bone so much that it will damage organs
заключенные в черепе baby

Identifying this pathology is easy enough – for this there are
characteristic external features, therefore instrumental and
laboratory diagnosis does not have any meaning. Treatment
кефалогематомы выбирается доктором совместно с мамой baby ATне
tactical dependence (surgical or conservative),
hemorrhage is successfully treated and, most often, does not leave
каких-либо последствий для baby

Frequently asked questions from patients

ATопрос: Останется ли косметический дефект после
cephalohematomas?

If a произошло саморассасывание гематомы или она была
timely punctured, then no. When replacing blood
connective tissue, in place cefalohematoma remains small
bone deformity. As a rule, in older age, it is invisible,
and it can be detected only after careful probing.

ATопрос: Надо пунктировать кефалогематому или нет?

There are no clear indications for puncture, however, doctors recommend
remove cefalohetoma with a volume of more than 70-100 ml.

ATопрос: Может ли расти кефалогематома и что делать
in this case?

Yes maybe. This is an unfavorable sign and, more often,
indicates continued bleeding. Tactics by
родителей одна – немедленно обратиться к to the doctor.

ATопрос: Что лучше – пункция кефалогематомы или
conservative treatment?

Each treatment method has its pros and cons. With
conservative tactics there is a risk of hematoma organization (replacement
connective tissue). After surgical treatment there is a small
probability of wound infection and re-formation
cephalohematomas.

ATопрос: Опасно ли делать детям операцию в области
heads?

With специализированной врачебной помощи – нет.

ATопрос: Может ли кефалогематома исчезнуть
on your own?

Yes of course. AT большинстве случаев рассасывание происходит в
for 2 months. However, in some patients, the body is not inclined
to the resorption of blood, and to the replacement of a clot by connective tissue.
Это не патология, а особенность организма baby

ATопрос: Что делать с окостенелой кефалогематомой?

There are two options. If a она не имеет большого косметического
values ​​and does not reduce the quality of life – it is better to leave it and not
delete. AT том случае, if a устранение дефекта имеет принципиальное
value, at the age of the child is possible
plastic surgery.

ATопрос: If a все-таки придется вскрывать, то, как
This procedure goes through whether it is necessary to go to the hospital for this. if a
yes, by how much?

Puncture cephalhematoma takes 5-10 minutes. To do this, do not
госпитализировать baby An experienced surgeon / pediatrician
small operating room and the availability of the necessary tools. Passes by
puncture as follows:

  1. Area cefalohematoma anesthetic anesthetic (novocaine or
    lidocaine) and disinfect;
  2. A syringe of sufficient volume evacuates blood from
    subperiosteal space;
  3. Antiseptic lubricate the puncture area and impose
    Aseptic dressing for 2-3 days.

The procedure is safe for the child and rarely leads to
infectious complications.

ATопрос: Cefalohematoma может вызвать желтуху?

Yes. With большом объеме кефалогематомы или ее быстром
resorption, there may be a slight yellowing of the mucous eyes,
mouth and skin. This is due to the breakdown of blood cells, residues
which turn into bilirubin. Child’s body не может вывести
a large amount of this substance, so bilirubin is delayed
in the tissues. Treatment, как правило, не требуется.

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