Caput succedaneum is an injury that a newborn can sustain during natural vaginal birth. It causes a swelling over the top of the infant’s skull that disappears completely within a short time.
What is a caput succedaneum?
By caput succedaneum, doctors mean the birth swelling popularly known. In medicine, caput succedaneum is classified as a specific trauma that can develop in a newborn as a result of childbirth. During a natural birth, the so-called vaginal birth, an edema or hematoma may develop in the newborn. This is when a small amount of blood or tissue fluid leaks from blood vessels due to vascular damage and accumulates in a cavity. The fluid is located between the cells and is distributed in the head over several bone plates. The hematoma is also called a subgaleal hematoma. In this case, the blood accumulates below the tendon plate of the skull. The hematoma occurs over the top of the skull between the head rind and the bones. The cephalic rind is a resistant tissue composite consisting of the scalp, a layer of connective and fatty tissue below the skin, and a tendon cap. It is located above the top of the skull. The caput succedaneum is formed between the tendon hood and the periosteum. This is a thin layer of tissue that covers the outer surfaces of all bones found in the body and has a regenerative function for the organism.
Causes
During childbirth, the head of the still unborn child is stuck in the birthing woman’s pelvis for some time. Due to the strong pressure built up in the birth canal during this process, the outflow of blood from the head is greatly impeded in the child. In addition, the child’s oxygen supply may be reduced. This leads to dilatation of the vessels and increased permeability. The outflow of blood should take place via the veins of the scalp and is prevented from doing so by the narrowness of the birth canal. The persistent pressure in the birth canal on the child’s head cannot be compensated by the organism. Since the human scalp is a very well perfused part of the human body, the congestion of blood can cause vascular damage and blood to leak from the veins. Due to the increased permeability, edema in the child is the result. This is when a swelling forms in which blood and tissue fluid have accumulated under the skin as well as in the cellular tissue. Another cause of caput succedaneum, in addition to natural vaginal birth, may be forceps delivery or the use of a suction cup during delivery.
Symptoms, complaints, and signs
Caput succedaneum is a swelling on the head, consequently the part of the child’s body that generally precedes birth. In other forms of birth, the caput succedaneum is rather not to be expected, because here, as a rule, there is no sustained pressure on the head of the child. The hematoma causes an unpleasant to slightly painful sensation in the newborn child when touched or when further pressure is applied to the area. Therefore, reactions such as turning the head away, crying or screaming can be expected for a short time. A lasting reaction due to triggered pain is not to be expected from the child, since the hematoma is not a severe or long-lasting pain. The texture of the caput succedaneum is described as edematous and doughy. The color of the hematoma is often slightly bluish.
Diagnosis and course
Diagnosis of caput succedaneum occurs after birth by palpation and visual inspection by a medical professional. The swelling is to be differentiated from other diseases or swellings in its nature as well as coloring by a physician. Palpation is an integral part of the basic techniques in a manual examination of the newborn. In this form of clinical examination, one or more fingers are used to palpate the body structures to locate the hematoma on the head and determine its nature. The caput succedaneum is usually about three to four centimeters thick. It crosses the cranial sutures and moves accordingly with gravity or by applying gentle pressure with the fingers. The hematoma is easily dented when pressure is applied with the fingertips.
Complications
In most cases, caput succedaneum does not result in further complications or discomfort. The swelling appears immediately after birth and in most cases disappears after a short time. Neither the mother nor the child experiences any further discomfort. The swelling itself occurs directly after the birth and can cause pain for the child. In most cases, the pain occurs mainly during movements of the head, so that the child begins to cry or scream. As the swelling itself quickly disappears, so does the pain. If necessary, the swelling may be blue in color. Even though the caput succedaneum can become relatively large, the symptom swells up again on its own. However, it may take up to a week for the symptom to completely disappear. The child’s head movements are restricted during this time. Parents must also pay special attention to this region and take care of it. The regression occurs on its own, without the need for medical intervention. Further complications and discomfort do not occur.
When should you go to the doctor?
Caput succedaneum does not usually require medical treatment. The swelling goes down on its own after a few days and rarely causes complications. However, if the swelling causes pain or severe discomfort in the child, it is best to tell the attending physician. He or she can take another look at the injury and prescribe a gentle, pain-relieving medication if needed. If the caput succedaneum has not receded after a few days, there may be another problem that needs to be investigated and treated if necessary. If the child shows behavioral abnormalities or still feels pain a few weeks to months after birth, this indicates a serious complication. In this case, parents should consult the pediatrician immediately. Basically, however, a caput succedaneum is harmless and only needs to be observed well. Parents who are nevertheless worried are best to talk about their fears with the doctor in charge.
Treatment and therapy
Caput succedaneum can assume grotesque proportions. Nevertheless, it usually regresses on its own in about a week after birth. In most cases, a marked regression can be seen or complete swelling has occurred as early as one to two days after birth. Lightly cooling compresses can be applied to the area for support. The child and the head area should be spared overall during this time. Medical intervention is not necessary in the case of a caput succedaneum, as regression usually occurs spontaneously. There are also no further medical treatment measures performed for the caput succedaneum.
Outlook and prognosis
As a rule, caput succedaneum does not have a severe course and complete recovery. Direct treatment of the disease does not need to be carried out in this case, as the symptoms usually disappear again on their own. The swelling goes down by itself a few days after the birth and there are no special complaints or consequential damages. The healing process can be supported by cooling compresses to relieve the swelling. Medical treatment is not necessary, however, so that Caput succedaneum will heal in any case. The child should be spared until the swelling has subsided completely so that no further injury or swelling occurs. After the swelling has subsided, however, the child can move and develop freely again. The healing process can also be accelerated by taking vitamin K. Likewise, most children receive a bandage to keep the wound clean. This also promotes healing. Caput succedaneum does not negatively affect or otherwise reduce the life expectancy of the affected individual.
Prevention
There are no preventive measures that could be taken for caput succedaneum. At most, birth other than vaginal birth in which the head does not precede could be considered as a preventive measure. Likewise, the use of forceps or a suction cup would have to be avoided. However, this is not advisable, since it is not a serious condition and the swelling disappears completely within a few days.
You can do it yourself
A birth defect usually does not require any special self-help measures. Parents only need to make sure that the child takes in enough vitamin K, because the substance promotes blood clotting and thus also wound healing. In addition, a caput succedaneum must be cared for hygienically. The dressing should be changed several times a day and the hematoma treated with an ointment prescribed by a doctor. If an open wound is also present, a sterile dressing must be applied and also changed regularly. The doctor in charge will inform the parents about what measures to take. Treatment with medicines suitable for children is necessary in any case. Home remedies and natural remedies should be avoided, because if used incorrectly, the lump can become inflamed and cause permanent damage. Cooling compresses that can be applied two to three times a day are permitted. If the child is spared and is otherwise healthy, the caput succedaneum should disappear within the first week of life. If it does not, the child must be examined again by a physician.
