Birth trauma head newborn hematoma. Complications caused by cephalohematoma on the head include. Causes of injury

Throughout history, repeated cases of trauma to the child during childbirth are known. Quite often, during childbirth, a child receives a hematoma, and this is even if we take into account the elasticity of the bones of the skull and natural shock absorbers - fontanelles. A hematoma in a newborn child is nothing more than a hemorrhage in soft tissues, where there is a gradual accumulation of blood and its thickening, but the blood is outside the vessel. In this article, we will tell you about what are the causes of the appearance of a hematoma and how you can cure the trouble that has arisen.

Causes of hematoma in a newborn

Hematoma may be caused huge pressure, which the child experiences at the time when he passes through the birth canal of the mother. In this case, it is worth considering the lymph that stagnates in the tissues of the child, the difference in pressure inside the mother and outside. Moreover, the second reason is much more common, because the child experiences a lot of pressure, and this can cause capillaries or blood vessels to burst. As a result, the child will bleed and form a hematoma. It should be borne in mind that a hematoma can occur not only on the head of a child, but also on any part of his body.

Quite often, you can encounter such a type of hematoma as cephalohematoma, which manifests itself in the form of swelling on the head of a crumb. More precisely, the child develops a hematoma between flat bones skull and periosteum. At the same time, the child's skin color does not change, but the presence of chiseled hemorrhages can be noted. An equally common cause of hematoma is the birth of a child much earlier than expected.

How to treat a hematoma in a newborn

If you believe the doctors, then a hematoma is quite normal phenomenon and don't worry too much about it. In about 10 days, the hematoma should disappear on its own, but if this does not happen, then you need to see a doctor. In the hospital, if necessary, the doctors will drain the child's blood with a syringe and remove a special liquid.

Such a procedure is completely safe, but it is necessary, because otherwise the child will begin to form pus, which will soon turn into a cyst and end result there will be a deformity of the baby's head. If there is a suspicion that the child begins to form pus, then you should immediately be examined and contact the surgeon.

It is also necessary to treat a hematoma when it begins to bleed or begins to increase in size. This is especially necessary if the hematoma is on the child's face. To date, there are two ways to treat a hematoma in a newborn: medical and surgical.

If the doctor chooses drug treatment, then he prescribes steroids to the child, which will slow down the growth of the vessels from which the hematoma has formed. The appointment may take several weeks or even months. Of course, the duration of treatment should also be determined by the doctor. Due to steroids, the child's appetite may worsen, mood will change very often, swelling of the face will occur, growth will be somewhat slow, and stomatitis may occur. No need to worry, all this will disappear after you stop taking the drugs.

As surgical treatment the doctor may use a scalpel or a laser. With their help, the vessels of the hematoma are destroyed or it is cut out completely. In order to choose the right treatment, you must first consult with a dermatologist and pediatrician.

If the hematoma is small, then treatment is not prescribed. What can be picked vitamin complex for a newborn.

The appearance of a hematoma on the head of a newborn is due to the influence of many factors. More often, it is formed due to an injury received by the child during the birth process, which leads to the concentration of a large amount of blood in the infant's skull and may bulge in the form of a bump.

There are several types of hematomas. Used in treatment medical preparations. But even if the size of the hematomas is large, the hemorrhage resolves on its own in the presence of concomitant factors.

About hematoma

Hematoma in a newborn develops due to rupture of blood vessels. It is formed due to the influx of a large amount of blood into the space between bone tissue head and skin. The neoplasm appears during the birth of the crumbs and sometimes looks like a bump on the head.

The presence of such bumps on the first day of life is a normal phenomenon that often does not negative impact on a newborn. After a few weeks, the condition of the baby's skull returns to normal without third-party intervention.

Causes

Thanks to anatomical features the structure of the baby's head, it is deformed when passing through the birth canal. This is due to the fact that the bones of the skull in babies are flexible, and between them there are 2 fontanelles. But in cases where a pregnant woman narrow pelvis, or the child's head is larger than the size of the birth canal, the bones of the skull are compressed, resulting in a hematoma in newborns.

Usually, even in the presence of these factors, children are born without visible defects.

A high probability of tumors on the skull is observed in the following cases:

1. the fetus is premature (a hematoma appears, even if the pregnancy proceeded without complications);
2. required a caesarean section;
3. vacuum extraction was used to extract the child.

In the last two cases, the tumor is formed due to sharp drop pressure. Because of this difference, the blood vessels that lie in the subcutaneous layer do not withstand and burst.

Symptoms

Hematoma usually does not pose a threat to the health and life of the child. In order to avoid the development of negative consequences for newborns with such neoplasms, dynamic surveillance. In particular, the doctor regularly monitors the size of the head and evaluates appearance tumors.

Most often, the bump in newborns resolves on its own within the first two months after birth.

Medical attention will be required when the following phenomena are diagnosed:

• increased excitability;
• while sucking milk flows;
• weak sucking reflex;
• anxiety, poor sleep;
• regurgitation in large volumes;
• asymmetrical structure of the face;
• chin shaking while crying;
• strabismus;
• the child often throws his head back;
• low tone.

Appearance indicated symptoms indicates a violation brain activity. without rendering specialized care hematomas on the head in newborns cause developmental delay and other Negative consequences. In other cases, the tumor develops asymptomatically.

Types of hematomas in newborns

Hematomas in newborns are of the following types:

1. cephalohematomas;
2. intracerebral hematoma;
3. subdural;
4. epidural.

cephalohematoma- this is the most common type of tumor that forms against the background of a rupture blood vessels. It is characterized by the fact that fluid accumulates in the space between the periosteal tissue and the skull. When it comes to postpartum hematomas on the head of a baby, they mean exactly cephalohematoma.

In the second type of neoplasm, vascular damage leads to the fact that blood penetrates directly into the brain tissue. Such a lesion requires immediate medical attention.

subdural hematoma characterized by accumulation of blood under the lining of the brain. The tumor develops mainly in weakened children or after childbirth, which proceeded with complications. In treatment pathological condition drug injections are used.

epidural hematoma develops against the background of rupture of blood vessels that lie between the membrane of the brain and bone tissue. No emergency surgical intervention the tumor causes the death of the child.

What is the difference between a birth tumor and a hematoma

Hematoma must be distinguished from a generic tumor. Outwardly, both formations look like a bump that appears on the surface of the head. Such a bump, due to the accumulation of fluid under the skin, changes its original position when pressed. The birth tumor remains motionless under mechanical action. In addition, a hematoma is formed on one cranial bone.

Any neoplasms require a specialized examination. Only a doctor can distinguish between a birth tumor and a hematoma.

Observation

In the absence of the previously described symptoms and dangerous forms hematomas within a week after birth, dynamic monitoring of the state of the baby's head is carried out. During this period, the doctor evaluates the changes that occur with the tumor. The tumor usually resolves on its own within two weeks.

To exclude the possibility of developing life-threatening hematomas, the child is examined using MRI and ultrasound machines. If necessary, a puncture is prescribed, through which the liquid is removed.

Cephalhematoma in newborns

A cephalohematoma is a collection of blood formed as a result of a rupture in the space between the bones of the skull and the periosteal tissues. In fact, it is a bruise formed on the head. A hemorrhage that has occurred in one place leads to the appearance of a noticeable bump on the surface of the head.

The bruise of babies in most cases does not bother. Its appearance does not cause pain. Hematomas on the head of a baby after childbirth in most cases do not pose a threat to the life and health of the child.

Causes

Cephalhematoma is formed due to the pressure experienced by the cranial bones when the child passes through the birth canal of the mother. Due to the severe deformation of the head that occurs during this period, there is a rupture of the vessels of the head.

The following factors can provoke the appearance of a hematoma:

• the narrow pelvis of the woman in labor or the large head of the fetus;
• abnormal presentation, due to which the birth canal is not fully disclosed;
• aborted fetus.

TO probable reasons tumor development also include insufficient volume of amniotic fluid. The head of the child in such circumstances remains dry.

Signs of cephalohematoma

A cephalohematoma is a neoplasm that looks like a bump. Its surface preserves the natural color of the scalp. When examining the problem area, pinpoint hemorrhages are found.

During the first days after birth, the size of the cephalohematoma increases. This is due to the fact that newborns have poor clotting blood. After about 7-10 days, the size of the tumor begins to decrease. And after 8 weeks, it completely disappears.

The duration of the development of cephalohematoma directly depends on the size of the child's head: the larger the latter, the longer the process of tumor resorption takes.

Suppuration of cephalohematoma

Suppuration of a cephalohematoma occurs when the tumor in a newborn does not resolve within two weeks. In such circumstances, the child should be sent for treatment. The appearance of pus inside the tumor provokes the development different consequences up to sepsis and death.

This complication arises from medical errors admitted in the treatment of tumors. In the fight against cephalohematoma, a puncture is used, which involves performing a puncture in the problem area. If the procedure is carried out without antiseptic treatment tools, they bring in open wound an infection that provokes suppuration of the hematoma.

Treatment of cephalohematoma

Treatment of a hematoma on the head in the normal course of events is not carried out. When symptoms appear that indicate the development of complications, the child is given injections of solutions, which include:

1. calcium gluconate;
2. vitamin K.

Substances stop bleeding and increase clotting.

Doctors prescribe surgery if the size of the cephalohematoma exceeds 8 cm in diameter. The procedure involves performing a puncture in the tumor and pumping out blood. With suppuration of the neoplasm, it is also opened and treated with antiseptic solutions.

Consequences and complications of cephalohematoma

Doctors distinguish the following consequences caused by cephalohematoma:

• anemia;
• jaundice;
• ossification and suppuration of the tumor.

These complications develop against the background of active blood flow to the neoplasm.

Caring for a child with cephalohematoma

A baby with a cephalohematoma requires close attention until the tumor completely disappears. It is important for parents to keep track of any changes that occur with the child. It is important not to injure the head of the newborn, thereby preventing the growth of the tumor.

If the neoplasm continues to grow after 7-10 days, or the newborn becomes restless, it is necessary to seek help from a doctor.

Treatment of hematoma in newborns

Hematoma in newborns requires treatment if the following conditions are present:

1. the tumor continues to grow;
2. does not resolve within 7-10 days;
3. noticeable signs of suppuration of the neoplasm;
4. symptoms indicating nervous disorders were revealed;
5. diagnosed with subdural or epidural hematoma.

If the last tumors in the newborn on the head are detected, treatment is carried out immediately.

To remove the neoplasm, 2 punctures are made in it, through which needles are inserted into the hematoma. Through the first pumping of blood is carried out. The second needle is necessary in order to prevent a pressure drop.

For large hematomas indicated treatment supplemented by taking specialized drugs in the form of injections. Children who have weak blood clotting are prescribed hemostatic drugs.

During the recovery period, it is desirable to provide access to the newborn to breast milk.

Forecast

With a hematoma of the baby's head, it is possible to determine whether it is dangerous only through a specialized examination of the child. For this, the newborn is placed in an MRI machine, through which the condition of the skull and brain is assessed.

Most patients have a favorable prognosis. Complications usually develop when treatment is not carried out.

Complications

It is impossible to predict in advance what consequences a hematoma will cause. Among the possible complications that have arisen against the background of a neglected tumor include:

• skull deformity;
• developmental delay;

Such complications are extremely rare. At the first changes in the behavior or condition of the child, you should consult a doctor.

Prevention

It is impossible to prevent the development of a hematoma on the head after childbirth. Tumors are often formed for reasons beyond the control of the pregnant woman. In particular, it is difficult to avoid a caesarean section, which is carried out for medical reasons.

To reduce the likelihood of hematoma, it is recommended to carefully monitor the course of pregnancy, trying to avoid fetal hypoxia.

Numerous protective measures, thought out by nature and accompanying the process of the birth of a child, do not always work 100%. A hematoma on the head of a newborn child is considered not so rare. The elastic bones of the baby's skull are able to converge and diverge due to the presence of fontanelles, which allows you to pass through the narrowest places. But it happens that at some stage the inherent mechanism does not work, which leads to the appearance of a cavity filled with blood. In the vast majority of cases, such troubles go away on their own and without a trace. Despite this, the condition is subject to careful monitoring and, in some cases, intervention by doctors.

Hematomas in newborns: causes, types, risk factors

A hematoma is a formation that occurs as a result of damage to blood vessels and impregnation of nearby tissues with blood. During childbirth similar phenomenon can affect any part of the child's body, but it is the head that most often suffers. Experts identify two main reasons for the formation of a hematoma in a newborn:

1. Compression of tissues at the time of passage of the fetus through the birth canal.
2. Sudden and significant pressure drop in children's body, which occurs during a rapid transition from the internal environment to the external.

Pregnant women should be aware that the risk of developing given state increases due to the following factors:

• Childbirth on too early term, prematurity of the fetus.
• The discrepancy between the circumference of the head of the fetus and the lumen of the birth canal of the mother.

Tip: The risk of a child developing a hematoma due to a sharp change in pressure is one of the contraindications for a caesarean section at will. Do not resort to this measure unless the doctor considers it necessary.

• The need for vacuum extraction.
• Too large fruit.

Regardless of the cause, a hematoma on the head of a newborn can be represented by the formation of one of the following types:

• . Most frequent view problem that occurs in 2% of babies. In this case, blood accumulates between the periosteum and the skull.
• intracerebral education. Blood enters the brain tissue.
• epidural hematoma. The most dangerous and difficult type of condition in terms of treatment. Rupture of blood vessels occurs between the solid meninges and cranial bone.
• subdural hematoma. Blood enters under the dura mater.

In some cases, hematoma in newborns cannot be determined by examination. Therefore, at the slightest suspicion of a condition, it is necessary to conduct a series diagnostic measures to confirm or refute the diagnosis.

The need for observation and methods of treatment

If the hematoma on the head of the newborn resolves on its own within 10-14 days, doctors note a favorable outcome of the injury. It is worth considering that large formations disappear more slowly than minor ones. Even specified dates exceeded, this is not always a warning sign. If the condition of the baby is not accompanied additional symptoms, and the formation is gradually decreasing, there is no reason to worry. An ultrasound, MRI, CT scan, or X-ray of the brain can be done to confirm that all processes are going well.

When time passes and there is no improvement, doctors decide to perform a surgical procedure aimed at reducing the volume of the hematoma. For its implementation, two needles are used. With the help of one, blood is pumped out of the resulting cavity, the other prevents the formation of negative pressure in this area.

The puncture procedure followed by aspiration is quite simple and gives instant positive effect. If the hematoma in the newborn was of impressive size, then the doctor may prescribe certain medications. With slow blood clotting, it may be vitamin K or calcium gluconate.

In addition to observation and surgical intervention on this stage it is very important to feed the baby breast milk. Only thanks to this, the baby will receive the substances necessary for quick recovery and prevent complications.

What is the danger of a hematoma?

Although doctors do not regard most hematomas in newborns as serious injuries, these conditions in some cases are fraught with a certain danger.

• If treatment is not started on time, the formation may fester.
• Accumulations of blood, if they are impressive, must be disposed of as early as possible, while they still have liquid consistency. Otherwise, the formation may harden, which will lead to a change in the shape of the baby's head.
• Jaundice sometimes develops against the background of large hematomas. This is due to the absorption of blood tissues and the release of a significant amount of bilirubin.
• If blood loss is palpable, there is a decrease in hemoglobin levels.
• In case of violation of the integrity of the skin in the area where the hematoma is located, tissue infection may begin.
• One of the most serious complications after a birth injury is a delay in the development of the baby, very rarely this provokes cerebral palsy.

In the event of a hematoma forming on the head of a child, parents are advised not only to rely on the professionalism of doctors, but also to carefully monitor the condition of the baby. If at least one of the following symptoms appears, it is urgent to run to a neurologist:

• The baby is different hyperexcitability or restlessness, he sleeps badly at night and during the day.
• Appetite is almost absent, the child takes the breast lazily, sucks not actively and chokes. Often vomits copious amounts of food after meals.
• Observed intestinal colic delivering to the baby severe discomfort. The newborn responds poorly to specialized treatment.
• The baby tries to throw his head back, constantly turns or tilts it to one side.
• From the eye it is noted profuse lacrimation(only one side suffers).
• The muscular apparatus is in hypotonicity.

To correctly assess the situation, it is necessary to understand the difference between a hematoma and a birth tumor. In the first case, the lesion is noted in the area of ​​​​only one bone, the one that was injured. Pressing on the formation causes it to diverge in waves to the sides. And the tumor can capture several bones at once. When pressed, it does not move and does not move.

Childbirth is natural physiological process involving both the woman and the child. Obstetricians try to help the baby be born without injury. But it is not always possible to avoid complications. One of the most common forms of injury is a hematoma on the head of a newborn. Why is this happening and what moms need to know about treatment.

Causes of postpartum hematoma

When the skin remains intact, but the blood vessels in the soft and muscle tissues, a hematoma (or bruise) forms on the head or in another part of the body. Blood accumulates at the site of injury, forming a kind of cavity. In newborns, the main cause of the pathology is considered to be pressure on parts of the body (mainly on the head) when passing through the birth canal. Hematomas are also formed during a pressure drop, when a crumb from the internal intrauterine environment abruptly enters the external one.

Most often, such injuries are received by premature or large babies, whose skull size does not match the lumen of the maternal birth canal.

Also, bruises are obtained with:

• pelvic presentation of the fetus;
• narrow pelvis of a woman;
• insufficient amount of amniotic fluid;
• delivery method caesarean section;
• overlay obstetric forceps or the use of vacuum extraction.

Hematomas in a newborn born at term, with a normal birth without the use of a vacuum or forceps - a reason for clarification true reason their occurrence. The child may suffer from diseases that worsen blood clotting.

Types of hematomas in babies on the head

There are several types of hematomas that appear after birth:

• Intracerebral- in which the hemorrhage affects the brain. This occurs when there is a lack of oxygen and the development vascular pathologies in the baby's body. The likelihood of such hematomas in a newborn increases due to physiological features(weak vessel walls, lack of minerals, thin skull bones, etc.).
• epidural- characterized by a vascular rupture at the point of convergence of the bones of the skull. It is considered the most severe and dangerous. calls seizures, pathological expansion pupils, changes in the fundus.
• Subdural- giving the passage of blood under solid structures.
• cephalohematoma- with which about 2% of children are born occurs when blood accumulates between the cranial bones and the periosteum. The bruise is clearly located along the contour in one of the regions of the skull (occipital, frontal, temporal, parietal).

Weak labor activity is a direct indication for mechanical intervention in the process of extracting the fetus. The consequences of such manipulations are a perineal rupture in a woman in labor, a cephalohematoma in a newborn. Outwardly, it looks like a bump, and its size depends on the severity of the injury. Hemorrhage can completely repeat the kennels of the bone and have a rectangular, triangular shape, depending on the location.

On palpation, it can be noted that:

• in the center it is soft;
• a seal is felt along the edges;
• the child, when pressing on the problem area, feels pain, begins to cry and reflexively defends himself.

If the cephalohematoma does not have clear boundaries, the swelling occupies more than one area of ​​the bone, lasts up to 2-3 days, then this is a generic tumor. It also occurs when the fetus passes through the birth canal, but does not require treatment and medical supervision.

What supervision is necessary for a newborn

Hematoma after childbirth should resolve in 10-14 days. Although the timing is highly dependent on the general condition of the newborn and the size of the subcutaneous hemorrhage. The larger it is, the longer it will take. There have been cases in which the complete disappearance of the bruise occurred in a few months.

Self-resorption of accumulated blood, in which the baby does not experience pain, is a favorable outcome of a birth injury. If the process is delayed, complications arise, the doctor directs the child to:

• ultrasound diagnostics;
• radiography;
• computed or magnetic resonance imaging of the head.

After reviewing the results of the examination, the pediatrician prescribes the appropriate treatment.

Head hematoma treatment

When there is no improvement, doctors decide to pump out the accumulated blood. For this, special devices (needles and syringes) are used. Sometimes it is necessary to treat a hematoma in this way several times. Physicians may also use drainage system. A tube is placed in the wound to allow blood to flow out of the damaged area.

If we are talking about cephalohematoma, it must be taken under control and treatment begins. The child may be given antibiotics to keep the bacteria from growing in the stagnant blood. Outside, bruises are smeared with ointments. Most often it is Tramumel C or Arnica. If the hematoma diverges slowly due to poor blood clotting in the newborn, hemostatic and vascular strengthening drugs are prescribed.

Children with cephalohematoma or other head hematomas require special care.

• follow all doctor's instructions;
• do not resort to home treatment. The baby may react unpredictably to various folk blood-dispersing methods and recipes;
• the baby's head must be protected from bumps, falls, abrasions;
• the place of hemorrhage cannot be squeezed by putting a tight cap or cap on the crumb. This will cause him pain;
• the size, color and shape of bruises must be monitored. If they increase, then serious occasion to contact doctors;
• give a child with a hematoma comfortable position can be done with a gel pad. This is a special device that distributes pressure on different areas of the head and significantly reduces discomfort.

By following these rules, parents will speed up the recovery of their baby.

What complications can occur

Doctors assure young parents that if this is a small bump that quickly resolved without medical intervention, then you should not worry. But if a large hematoma formed in the crumbs, which for some reason was not pumped out on time, then the risk of infection is greatly increased.

Scratches, cuts or other mechanical damage bruise. It begins to fester or harden. It will not work to remove it with a needle, and you will have to carry out surgical operation. Suppuration is difficult not to notice.

The inflammatory process is characterized by:

• redness of the skin around the area of ​​injury;
• seal;
• an increase in body temperature;
• weakness, lethargy of the child.

Hardened blood structures put pressure on nearby vessels and organs, disrupting their work. The newborn is naughty, eats poorly, sleeps little. He suffers from headaches, experiences constant discomfort. Intracerebral hematomas, in contrast to superficial cephalohematoma, lead to developmental delay, speech and motor function disorders. IN severe cases cerebral palsy may develop.

It is necessary to show the newborn to a specialist with:

• hyperexcitability, irritability;
• insomnia;
• poor appetite;
• constant turning of the head in one direction;
• lacrimation;
• muscle hypotension.

Blood accumulated in the hematoma can enter the bloodstream and cause an increase in bilirubin levels. Therefore, it is often caused by birth hematomas. The disease drags on, flows into pathological form. In children with ossified hematomas on the head, a curvature of the skull is noted. If you do not engage in treatment, then it will be difficult to correct the situation later.

As a preventive measure future mommy should lead healthy lifestyle life, do not overwork, carefully visit a gynecologist. It is necessary to take care of the maternity hospital in which the baby will be born in advance. Experienced Specialists in the course of complicated and difficult childbirth, they will be able to provide competent assistance to both mother and child.

You can also explore:

• (why it occurs and how to treat).

Birth injuries are damage to soft and hard tissues of varying severity and intensity, resulting from weak labor activity, the use of hardware methods of extraction (extraction) of the fetus, wrong position fetus in the uterus. Birth trauma in a child can be caused by erroneous tactics of childbirth, improper behavior of the mother during labor and the straining period, as well as mistakes medical staff taking birth. One of the varieties of birth injuries in newborns is a hematoma. A hematoma is a tumor formed as a result of damage to blood vessels during various injuries internal organs.

Most hematomas go away on their own within 2-4 weeks after the birth of the baby, but some of them require careful medical supervision and observation. One of these tumors is cephalohematoma - a hemorrhage that occurs between the bones of the skull and connective fibers (periosteum). Pathology occurs in about 3-5% of newborns and usually has a fairly favorable prognosis. IN rare cases cephalohematoma can cause disturbances in the functioning of the brain, and in 0.4% of children it can cause cerebral palsy.

The main reason for the formation of hematomas on the head in newborns is the pressure that the pelvic bones exert on the child's body while moving through the birth canal. The situation becomes more complicated if the size of the mother's pelvis does not match the circumference of the fetal head, and there is a risk of the head getting stuck in the pelvic cavity. Such women are shown delivery by caesarean section, but with premature and rapid birth, especially if the woman lives far from maternity hospital and does not have time to arrive at the maternity hospital on time, it is not always possible to perform the operation before the fetal head descends into the small pelvis.

During childbirth, periosteal tissue along with skin displaced, allowing the child to move through the birth canal of the mother. At this moment, damage to the blood vessels occurs, and between the bones of the skull and connective tissue a pocket is formed that fills with blood. Outwardly, the hematoma looks like a tumor or a small lump. Its size depends on the amount of accumulated blood. In some cases, it can reach up to 150 ml - this situation is considered clinically severe and very often requires surgical intervention. The average volume of blood that makes up a hematoma on the head is 5-50 ml.

Hematomas of the parietal and occipital part of the head can have three degrees of severity:

• Grade 1 - formation diameter ≤ 4 cm;
• Grade 2 - the diameter of the bruise is from 4 cm to 8 cm;
• Grade 3 (most severe) Tumor diameter ≥ 8 cm.

Varieties of hematomas in a newborn

Name	Image	What it is?
		A tumor formed as a result of damage to the blood vessels of the periosteum and localized between cranium and connective fibers of the periosteum
		Accumulation of blood under the dura mater of the brain
		Rupture of blood vessels and capillaries of the brain with subsequent formation blood stain in the brain space

Important! In no case should you refuse medical supervision if a child is diagnosed with a hematoma of the head. In some cases, bruising can be combined with a skull fracture and cerebral edema, so children with this diagnosis need comprehensive examination and expert supervision.

Causes of a hematoma on the head of a newborn

Experts identify several factors that increase the likelihood of the formation of cephalohematoma and other types of hematomas in the first day after the birth of a child. The risk group includes older women age group(in some subjects, women older than 30 years old are recognized as old parous), as well as patients with a history of fractures and other injuries of the pelvic bones or unsuccessful pregnancies and abortions. Incorrect behavior of a woman in childbirth, the imposition of obstetric forceps or a vacuum aspirator, premature, prolonged labor- all this increases the risk of a child getting birth injuries and hematomas.

Doctors also refer to other causes of pathology:

• large fetus (child weight over 4 kg);
• multiple pregnancy;
• cord entanglement in the second and third trimester;
• reflux of mucus in amniotic fluid, V Airways an infant and hypoxia and asphyxia developing against this background;
• fetal fetopathy (mainly diabetic type);
• hydrocephalus (accumulation cerebrospinal fluid in the brain)
• pelvic presentation of the fetus.

The risk of hematomas also increases if delivery occurs at 41 or 42 weeks of gestation. This is due to the excessive accumulation of calcium in the child's body, which leads to an increase in bone density and a decrease in their elasticity.

Important! Most of the pathologies of the fetus, which can cause rupture of the periosteum blood vessels during childbirth, can be detected even during pregnancy on planned ultrasounds, so a woman should undergo scheduled examinations and take the necessary tests in a timely manner.

Diagnostic features and clinical picture

Physiological tumors that are the norm (birth tumors) will be noticeable in a child on the first day after birth. They go away on their own and do not require any treatment. Hematoma can be diagnosed on the third or fourth day of a child's life: by this time, the tumor is slightly increasing in size due to the lack of enzymes that provide blood clotting. For the diagnosis of cephalohematoma and other types of hematomas, a medical examination is used, as well as ultrasound diagnostics. Ultrasound allows you to assess the size of the bruise, its localization and the presence of concomitant pathologies.

Ultrasound diagnostics is also necessary if other brain diseases are suspected, which may include:

• hydrocephalus - dropsy of the brain, edema caused by the accumulation of fluid in the ventricular system of the brain;
• hemorrhage under the aponeurosis of the brain;
• brain herniation.

During visual examination and palpation of the baby's head, an elastic formation with clear boundaries can be detected. When pressing on the tumor, fluid movement can be detected.

Note! In some cases, the doctor may order an X-ray examination, MRI diagnostics, or computed tomography. These diagnostic methods are rarely used in newborns, but in some cases, for example, if a skull fracture is suspected, they allow you to put accurate diagnosis and timely prescribe the right treatment.

Treatment of head hematoma in a newborn

Some mistakenly believe that a hematoma on the head does not need to be treated, and it goes away on its own. The tumor can indeed resolve on its own, but if measures are not taken to stop the bleeding, complications may arise, among which the most dangerous is cerebral palsy, as well as various forms physical and mental retardation. If the size of the hematoma is small (up to 4 cm), calcium preparations are prescribed to the newborn (" calcium gluconate"") intravenously, as well as liquid forms phylloquinone (vitamin K). Such treatment is carried out in the maternity hospital and takes no more than 3-5 days, therefore, in the absence of other pathologies and disorders, the mother and child will be discharged from the maternity hospital on the fifth or sixth day after childbirth.

At large sizes formation, a pediatric surgeon will perform a puncture of the tumor, during which blood will be sucked out of the formation, and blood clots. After the procedure, a pressure bandage will be applied to the wound surface, which must be changed regularly for 10 days.

Important! Children with any form of hematoma on the head should never be rocked - this can provoke an increase intracranial pressure and hemorrhage in the vessels of the brain. During the first 2-3 weeks, it is better to carry the baby in your arms or in a car seat for a walk. You can use a stroller, a mechanical cradle with a motion sickness function, electronic swings and chaise lounges with vibration when the child is one month old (subject to an uncomplicated course).

Purulent hematoma: what to do?

If the hematoma begins to fester, the child is transferred to surgery department children's regional hospital where he will have to stay for at least 1 month. Treatment in this case is always surgical. The doctor opens the wound, drains the tumor, removes pus and blood clots, and then applies a bandage with an antiseptic. For prevention inflammatory process and severe complications, the child is prescribed antibiotics. These are usually drugs penicillin series in the shape of intramuscular injections based on amoxicillin or ampicillin. If purulent process accompanied by fever, severe deterioration of health or severe intoxication, agents from the cephalosporin groups can be used, for example, " Ceftriaxone».

Treatment with antibiotics takes 7 to 10 days. To restore immunity and prevent intestinal dysbacteriosis, the doctor may prescribe prebiotics, for example, " Linex”, but the dosage, as well as the duration of use, should be selected only by a specialist, taking into account the general condition of the baby. After discharge from the hospital, the child is registered with pediatric surgeon and a neurologist and is observed at the place of residence.

Consequences of a hematoma in a newborn on the head

In about 88% of cases, hematomas in newborns disappear completely without any consequences, but sometimes incorrect medical tactics or lack of timely therapy can lead to severe complications. The most common of these is anemia (anemia). This disease, in which hemoglobin synthesis decreases in the child's blood, is necessary for binding to iron molecules and transporting oxygen to organs and tissues. Anemia in these children is the result of profuse blood loss caused by damage to the vessels of the periosteum of the brain. If anemia is not detected in time, the child may lag significantly behind in mental and physical development, have a neurological disease, as well as blood diseases.

Another pathology, occurring in about 7% of infants with various types hematomas on the head - jaundice. The blood that accumulates in the surrounding tissues breaks down and forms a large number of bilirubin, which enters the systemic bloodstream. It is very easy to determine jaundice in a child by characteristic symptoms(the main one is yellowing of the skin and eye sclera), but it is also important to carry out a set of differential diagnostic measures and exclude other severe ailments: cirrhosis, atresia of the biliary ducts, hepatitis.

Note! by the most severe consequence hematoma in newborns is cerebral palsy. In some cases, ossification of the formation may occur, leading to a change in the shape of the skull and head. Risk neurological diseases in children, even with small hematomas of the 1st degree, it is more than 50%.

General condition and development of children with hematoma

The consequences of a hematoma may appear even several years after the birth of a child, but most behavioral changes becomes noticeable already in the first months of a baby's life. Children with this diagnosis do not sleep well, may wake up somewhat during the night, fall asleep for a long time. They are sensitive to bright colors and loud, harsh sounds. When such a child reaches the age social adaptation(after a year), he has problems in communicating with peers. At home, such a child can often throw tantrums, be capricious, and refuse to eat. Approximately 4-5% of children complain of headaches that appear regardless of general well-being child.

Important! Parents should remember that yelling at a child who was diagnosed with a hematoma on the head after childbirth is in no case possible: this can worsen the child's condition and exacerbate existing problems.

If the behavior becomes completely uncontrollable, parents are advised to contact a psychologist. For normalization cerebral circulation and reduce the emotional load on the cells nervous system may be required drug correction, but only a doctor should prescribe any drugs.

Video - Causes of birth injuries

Video - Pediatric neurosurgeon about cephalohematomas