Difference between Caput Succedaneum and Cephalhematoma

CAPUT SUCCEDANEUM

Definition

A caput succedaneum is an edema of the scalp at the neonate’s presenting part of the head. It often appears over the vertex of the newborn’s head as a result of pressure against the mother’s cervix during labor. The edema in caput succedaneum crosses the suture lines. It may involve wide areas of the head or it may just be a size of a large egg.

Causes

  1. Mechanical trauma of the initial portion of scalp pushing through a narrowed cervix
  2. Prolonged or difficult delivery
  3. Vacuum extraction

The pressure (at birth) interferes with blood flow from the area causing a localized edema. The edematous area crosses the suture lines and is soft. Caput Succedaneum also occurs when a vacuum extractor is used. In this case, the caput corresponds to the area where the extractor is used to hasten the second stage of labor.

Signs and Symptoms

  1. Scalp swelling that extends across the midline and over suture lines
  2. Soft and puffy swelling of part of a scalp in a newborn’s head
  3. May be associated with increased molding of the head
  4. The swelling may or may not have some degree of discoloration or bruising

Management

  1. Needs no treatment. The edema is gradually absorbed and disappears about the third day of life.

Complication

  1. Jaundice – results as the bruise breaks down into bilirubin.

CEPHALHEMATOMA

Definition

Cephalhematoma is a collection of blood between the periosteum of a skull bone and the bone itself. It occurs in one or both sides of the head. It occasionally forms over the occipital bone. The swelling with cephalhematoma is not present at birth rather it develops within the first 24 to 48 hours after birth.

Causes

  1. Rupture of a periostal capillary due to the pressure of birth
  2. Instrumental delivery

Signs and Symptoms

  1. Swelling of the infant’s head 24-48 hours after birth
  2. Discoloration of the swollen site due to presence of coagulated blood
  3. Has clear edges that end at the suture lines

Management

  1. Observation and support of the affected part.
  2. Transfusion and phototherapy may be necessary if blood accumulation is significant

Complication

  1. Jaundice
Difference between a Caput Succedaneum and Cephalhematoma
INDICATORS CAPUT SUCCEDANEUM CEPHALHEMATOMA
Location Presenting part of the head Periosteum of skull bone and bone
Extent of Involvement Both hemispheres; CROSSES the suture lines Individual bone; DOES NOT CROSS the suture lines
Period of Absorption 3 to 4 days Few weeks to months
Treatment None Support

image from emedicine.medscape.com


Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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