Cranial injuries during the birthing process

Question 1

How does caput succedaneum present and what is its management

Answer 1

• Large oedematous swelling and bruising of the scalp
• Treatment not needed cos resolves by itself after a few days
• Caused by pressure on the fetal scalp during the birthing process

Question 2

How does cephaelohaematoma present and what is its management

Answer 2

• May occur after spontaneous vaginal delivery or following trauma from the obstetric forceps or ventouse
• Haemorrhage results after the presidium is shared from the parietal bone
• The tense swelling is limited to the outline of the bone
• Reduces over a few weeks-months so best to leave the area to allow the body time to reabsorb the collected fluid
• Usually doesnt cause problems for the newborn except more likely to be jaundiced in the first few days

Question 3

How does subaponeurotic haemorrhage present and what is its management

Answer 3

• Newborn loses large amounts of blood
• May require transfusion or volume resus
• Rare and due to a traumatic birth
• Aka subgaleal haemorrhage

Question 4

How does intracranial haemorrhage present and what is its management

Answer 4

• Can be a subarachnoid, subdural or intraventricular haemorrhage
• Subarachnoid more common and may cause irratability and even convulsions over the first 2 days of life
• Subdural following forcep use
• can occur spontaneously in premature neonates
• In neonatal practice it usually occurs in the first 72 hours after birth; Aetiology not well understood
• Treatment is largely supportive
• Hydrocephalus and rising ICP is an indication for shunting

Question 5

How can we distinguish caput succedaneum with cephalohaematoma ?

Answer 5

Cephalohaematoma does NOT cross the suture lines