Hematoma on the head of a newborn baby after delivery
Childbirth is a natural process for a woman, but it does not always go smoothly. For a newborn, birth is always a challenge. Sometimes the birth process is accompanied by injuries to the child. One of such troubles is a hematoma in a newborn on the head. Why it arises, whether it is dangerous and how to treat it, we will describe below.
Causes of hematoma in the newborn
This formation in the soft tissues of the head is formed as a result damage vessels and may be of different sizes. Immediately after birth, the effects of hemorrhage are not yet visible, they manifest themselves after a few hours, and sometimes days.
In the process of forming a lump becomes more pronounced. It may be on different parts of the body, but it is most common on the head. The reasons the occurrence of hemorrhage in the newborn on the head after childbirth may be the following:
- squeezing the head of the baby in the mother's birth canal,
- a sharp pressure drop in the transition of the child from the internal environment to the external.
The aggravating factors are: premature birth, rapid delivery, cesarean section, large size of the fetus, too narrow a mother’s pelvis. In premature babies, the vessels are less elastic and more easily damaged, leading to hemorrhage.
Worn children are also at risk, as their skull bones are firmer, the fontanel is already beginning to grow, which makes it difficult to pass through the birth canal. Fetal hypoxia is another reason that increases the likelihood of hemorrhage. The lack of oxygen in the tissues contributes to the fragility of blood vessels and the subsequent internal bleeding due to pressure drop in the uterus and immediately after birth.
Types of hematomas
Postpartum hematoma looks like a small soft ball of a bluish color, its texture is due to the accumulation of fluid at the site of injury. During the first 2-3 days after birth, an increase in education is observed, and on the 7-10th day it begins to gradually decrease in size. Most often a bump is found on the top of the head, but it can also appear in the region of the neck, the front of the head, or the side.
Doctors divide hematomas by 4 like:
- Cefalomegate Not too common education. In this case, blood accumulates between the cranial bone and the periosteum. Most often arises due to the narrowness of the birth canal and preterm birth.
- Subdural. Hemorrhage occurs under the dura mater. The cause of its occurrence may be seizures, requires the immediate intervention of doctors.
- Epidural. Clump The blood is located between the skull bone and the hard shell of the brain. Treatment can not be postponed, it can lead to death of the baby.
- Intracerebral. This hematoma is called cerebral hemorrhage, and is very dangerous in its consequences. It is the result of complicated labor and head injuries, most often it has a multiple character.
Symptoms and diagnosis
The head of a child with a formed hematoma looks asymmetrically, and the boundaries of the formation itself are always clearly delineated. The bump is soft to the touch, easily minimized, there is clearly a buildup of fluid inside. On the surface of the skin in the area of hematoma there are small dot hemorrhages of red color. Gradually, the skin color becomes bluish.
Baby at this time looks like sluggish and painful, often crying. Clicking on a hematoma in a newborn clearly hurts him. These babies have increased drowsiness. The decision about the need for examination is taken by the doctor, it is carried out in a hospital.
The doctor conducts an external examination, prescribes a blood test, an ultrasound examination and X-rays. These methods allow you to determine the exact size and depth of the hematoma, the presence of possible damage to the bones of the skull.
Is hematoma dangerous?
Formed hematoma remains unchanged for 1-2 weeks, and then most often resolves independently. As soon as the bump starts to decrease, the child will immediately feel better. The baby will be cheerful, start to sleep better and eat, stop crying often, in a few days the hematoma will significantly decrease in size and then disappear altogether.
If this does not happen, you need a medical intervention. This procedure is called "hematoma aspiration". It is carried out with the help of two medical needles, which will remove the accumulated blood. This measure helps to immediately rid the baby of all unwanted symptoms.
TO complications hematomas include:
- lack of appetite, frequent regurgitation, nausea and vomiting,
- increased nervous excitability and poor sleep in a child,
- gradual development of anemia due to large blood loss,
- the appearance of jaundice of the newborn,
- infection of the tumor contents and subsequent suppuration,
- ossification of hematoma, leading to deformity of the head.
Does the newborn require hematoma treatment?
Doctors take these kids under surveillance. The use of medications will not help get rid of the consequences of hemorrhage. Usually they wait when everything goes by itself. If, after a fixed period of time, spontaneous resorption of the soft lump does not occur, an operation is performed to open and remove the accumulated blood. But this is extremely rare.
If was held operation, the recovery of the child takes 15-20 days, after which he becomes completely healthy and in the future no unpleasant consequences are observed. Doctors do not consider hematoma a dangerous disease, although its manifestations can be quite unpleasant for a small patient.
Difference of a hematoma from a patrimonial tumor
Sometimes the hematoma is confused with a generic tumor, although the signs of these formations differ from each other by the location, texture and resorption time. Tumor formations are formed in several places at once, they can simultaneously be located not only on the head, but also on the child’s back or leg.
In the head area, the hematoma is always localized on one bone, and the generic tumor situated immediately on several. The tumor formation is dense to the touch, since there are no liquid contents inside. For this reason, the tumors dissolve much faster.
Now that you know more about the process of hematoma formation, there is no need to worry that the doctor is inactive and does not prescribe treatment. This is a common practice. According to statistics, such an injury occurs in 1-2% of the total number of newborns and does not threaten them with anything serious.
What is hematoma and how does it appear
The hematoma in a newborn baby is a kind of bruising in the tissues resulting from rupture of the blood vessels. This kind of education on any part of the body may appear, but they are most often observed on the head.
Why do such hemorrhages happen? When a baby moves through the birth canal, a lot of transformations are experienced by its head. Along with the high elasticity of the tissues in the process of moving the child through the mother's birth canal, intracranial ruptures of large vessels and small capillaries often occur. It is because of these gaps that a hematoma appears on the head of a newborn after birth.
Why does a hematoma appear on a baby’s head?
In medicine, there are two main reasons for the formation of hematomas in a newborn child:
- squeezing of the baby’s body parts and in particular of the head as it passes through the birth canal. The fetus in the mother's womb is located head down and the way to the way out he is laying it with her. In the still unformed child's skull, the bones are very flexible. When the skull is compressed during labor, as a result, bruises appear on the back of the head or on the crown;
- sudden changes in blood pressure in the body of a child when it passes from the mother's womb to the external environment. Being born is a kind of stress for an infant. Not every kid has such sharp pressure surges that withstand the walls of blood vessels. As a result, they burst and a hematoma forms on the baby’s head.
Although a generic hematoma on the head of a newborn occurs very often, but it is not formed in everyone. Among the factors that increase the risk of such injuries are:
- too long stay of the baby in the womb or its premature birth,
- a long break between the birth and discharge of water,
- narrow bones of the pelvis of the mother or the large head of the child,
- abnormal location in the birth canal of the baby,
- rapid delivery due to drug stimulation,
- improper removal of the fruit at caesarean section,
- the use of epidural anesthesia for the mother during childbirth,
- extraction of the child by the method of vacuum extraction.
In addition to these, there are many other reasons that result in a hematoma on the head of a child. Therefore, in order to identify and timely prevent possible risks even in the early stages of pregnancy, expectant mothers need to contact specialists in the antenatal clinic.
What are hematomas
Determining the hematoma immediately after the birth of the baby is quite difficult. This is due to the presence on the head of the generic edema. Only when the tumor comes down (usually this period is 1-3 days) can the pediatrician accurately state whether there are signs of intracranial hemorrhage or not.
Depending on the site of localization and the type, the effects after a hematoma on the head of a newborn may be different.
Such educations are diagnosed at a rupture of vessels and accumulation of blood between the bones of the head and the periosteum. Outside the bones of the skull, cephalhematoma does not spread and does not cause discoloration of the skin and painful sensations.
Depending on how this type of hematoma develops during childbirth in a newborn, the consequences can be different:
- with low blood clotting in the first days, it can rapidly increase in size, and after a minus of 9-10 days, it spontaneously resolves. Depending on the size of the formation, it completely disappears from 2 weeks to two months. All this time, the baby must be under the supervision of a doctor,
- if a newborn baby has a hematoma of more than 6 cm and at the same time its size has not decreased at all within two weeks, then on the 14th day after the birth of the baby, the doctors prescribe a puncture of cephalohematoma,
- if bacterial infection occurs through sores and abrasions, then periosteum tissue may rot. When it is impossible to eliminate the process by conservative treatment, it is urgent to remove the celematome.
It is important to know! If hematoma of the head in infants appeared due to an intrauterine or hereditary disease, then an operation should be carried out to urgently extract it.
Treatment cefalohematoma as follows:
- if the hemorrhage is small, then special treatment is not required. If necessary, the doctor may prescribe calcium and vitamin K intake,
- with bulk hematomas, the accumulated fluid is pumped out. To do this, use two needles, one of which is the removal of the contents, and the second is normalized intracranial pressure. For a child, such procedures are completely safe.
If a child has cefalohematoma, they should not sharply lift, rock or shake. Considering what a hematoma is in a newborn baby and possible negative consequences, until its complete disappearance, the baby must be under the supervision of doctors.
Such formations arise due to rupture of blood vessels located between the meninges and the cranial bone. If an epidural hematoma is diagnosed in a newborn after delivery, its consequences are quite dangerous. Already after 5-7 hours, substantial compression of the brain can occur in the brain tissues, as a result of which the condition of the baby rapidly deteriorates.
The shape of the formation of an epidural type resembles a lens 3-8 cm in diameter. According to severity, there are three forms:
- Easy, when less than 100 ml is the volume of blood.
- Average. Up to 150 ml of blood accumulates.
- Heavy Due to hemorrhage, hematoma contains 200 ml of fluid and more.
Note! The consequences of such formations are quite heavy. Failure to provide timely medical care is high risk of death.
To determine the epidermal formation can be on the following grounds:
- on the part of the hemorrhage, a marked dilation of the eye pupil,
- there is the effect of the "wandering pupil", while it does not react at all to light,
- baby's head is thrown back, in its occipital part there is muscle rigidity,
- frequent convulsions of suffocation
- increased intracranial pressure and low arterial pressure,
- loss of consciousness, vomiting and coma.
Depending on the severity of the damage, the symptoms may periodically intensify and ease. How and how to treat hematoma in newborns? If the baby has not shifted brain tissue, there are no neurological disorders and the size of the formations is minimal, then to eliminate their rather conservative treatment, the period of which is 10-14 days.
When the hematoma on the head of a newborn does not pass and the bruise does not decrease, it is removed by an operative method. With a liquid volume of up to 50 ml, a puncture is performed with a thin needle. If there is more fluid in the cavity, then through a specially made window, the blood and clots are cleaned. This is necessary to prevent complications and the formation of brain edema.
At ruptures of blood vessels between the soft and hard shell of the skull there is a hematoma in the head after delivery of the newborn, which is called subdural.
According to the severity of such hemorrhages are:
- sharp. Immediately after the birth of the baby, the pathology of venous hemorrhage is visible,
- subacute. Within 2-4 hours there are deviations of a neurological nature,
- chronic. Such a hematoma of the head during childbirth remains imperceptible for quite a long time, its effects and symptoms appear 6-30 days after the birth of the baby.
Depending on the degree of pressure on the brain, the speed and size of the bruise, the symptoms of subdural abnormal formation may be different:
- pupils differ in size,
- the eyeball is noticeably deflected to the side,
- there is no reaction to light
- vomiting occurs, respiratory functions are impaired,
- psychomotor overexcitement is observed,
- the head does not turn towards hemorrhage,
- tachycardia and convulsions,
- coma condition.
If a subdural hematoma in newborns on the head is not noticed in time, the consequences can be lethal.
The main task for extensive hemorrhages is to stop and remove blood as soon as possible. Pathologies of a chronic nature are cured conservatively. To do this, use drugs with hemostatic, analgesic, anti-edema effects, as well as diuretics and nootropic.
Intracerebral hemorrhages entail damage to nerve cells and are able to completely or partially sever neuromuscular ligaments. Very often this type of hematoma of the head in a newborn during childbirth is manifested by two or more bruises.
Instant effects are not characteristic of every hematoma. If pathology was not detected in the maternity hospital, then at home it can be recognized by the following symptoms:
- increased baby hyperreactivity or excessive lethargy,
- continuous crying
- constant regurgitation and poor or complete lack of appetite,
- deep sleep or insomnia,
- head deformation
- drooping towards the head, trembling in the legs and hands, chin twitching,
- direction to the side of the eyeballs
- disturbed breathing rhythm
- unnatural pallor or yellowing of the skin and mucous membranes of the eyes.
If you notice two of the above symptoms in your child, you should immediately consult a doctor to determine the diagnosis. When there are three or more signs, the probability of having intracranial latent hemorrhage is maximum.
When a hematoma appeared on the head due to intracranial hemorrhage, then using ultrasound to detect it even if it is possible, then this method will not show information about the size and tissue structure. Accurate data can be obtained only with CT and MRI studies.
If, according to the results of the blood test, there is an excess of platelets, then the child is sent to the surgeon to remove the hematoma.
Are hematomas dangerous and how
Faced with pathological formations in a child due to hemorrhages, parents wonder whether hematomas on the baby’s head are dangerous and what to do in such situations.
It should be understood that any abnormal formation may be a danger to the newborn. As for hematomas, each of the species can cause irreparable harm to the child.
What causes different types of hemorrhage in more detail presented in the table.
- Деформация черепных костей, вследствие чего голова малыша приобретает неправильные уродливые формы
- Blood loss causes anemia and hypoxia of the brain tissue.
- If blood gets into nearby connective tissue, jaundice may develop.
- The hematoma ossifies and a lump forms on the head of the baby
- Blood contamination can occur during suppuration
- Due to compression of the brain, the infant develops hypoxia and anemia.
- The process of physiological and mental development is impaired and slows down significantly.
- Disruption of the respiratory system
- Vision and coordination deteriorates until they are completely lost.
- Heart failure is observed
- Jaundice develops
- Lethal outcomes
- Mental retardation
- Cerebral palsy
- Epilepsy and the development of other psychiatric pathologies
- Dysfunction of the musculoskeletal system
If we analyze the consequences that a hematoma on the head can entail and how dangerous it is, it becomes clear that it is impossible to ignore suspicious symptoms. Even if they are causeless, it is better to go to the doctor and make sure that they are not available.
Remember! To avoid unpleasant consequences, it is necessary to give birth only in the hospital in a hospital. At home, the birth of a child is not recommended, even if the process takes place with the participation of a highly qualified midwife. One wrong move can turn into sad results, and rapid hemorrhages can cause an instant death of a child..
How to distinguish a hematoma from a generic tumor
Immediately after birth or during the process of giving birth to a child, a birth tumor is often observed in the occipital-parietal region. This type of formation is very similar to hemorrhage, but it is not a hematoma on the head of a newborn during childbirth.
Typical features of a generic tumor are swelling with spots or dotted blotches of cherry hue. The consistency of the formations is pasty, with their presence, the skin acquires a brownish color.
It is possible to distinguish a generic tumor from a hematoma by the following features:
- the tumor does not budge when it is pressed because it is very dense, the bruise changes its original shape quickly and seems to spread out under pressure,
- when a tumor is formed at once, several cranial bones are affected simultaneously while the generic hematoma on the head of a newborn, the consequences of which are much more dangerous, is localized only in the zone of one bone: occipital, temporal, frontal or parietal,
- tumors can appear simultaneously in several places (on the head, thighs, buttocks), bruises are formed only in one area,
- there are no clear borders at the tumor, they can cross the stitches of the adjacent areas,
- tumors mainly occur during the period when the amniotic fluid has departed and the birth is dry,
- tumors have no bone defects, they do not pulsate, in about 2-4 days they dissolve on their own.
What is more dangerous to the health and life of the baby: a bruise or a tumor? The second from the point of view of medicine are considered safe formations.
In most cases, the hematoma on the head of a newborn does not pose a special danger, when it passes, that state of health immediately improves and normalizes. It is only important to provide qualified medical assistance in a timely manner and to care for the child properly during the treatment process.
Hematoma after childbirth
Not only in the process of the birth of a baby can intracranial hemorrhages occur. Quite often, doctors diagnose a hematoma on the head of a newborn after childbirth, the consequences of which may even be more dangerous than in their process.
Immediately after the birth, the skin and bones of the infant are not yet fully formed and are highly sensitive to any external influences. In the soft tissues of the head, bruising may occur as a result of an accidental fall or hitting a nearby hard object.
In the first months of a baby’s life, the bony structures and joints of the cranial bones do not yet have sufficient strength, therefore, in addition to hemorrhage, such injuries can also be accompanied by concussions, bone fractures and meningocele.
How is neonatal hematoma treated as a result of a fall? First of all, it is necessary to examine the head and body of the child independently with the utmost care. If suddenly you notice even the slightest swelling or swelling, then this is already an alarm.
When at the same time the volume of the formations increases, and the skin over them becomes warmer, then urgently it is necessary to call an ambulance or bring the baby to the doctor on your own. At the reception, the doctor will conduct all the necessary studies to determine the diagnosis and prescribe the appropriate treatment.
Even in the absence of visible traces of injury on the baby’s body or head, the following symptoms should alert the parents:
- loss of consciousness may indicate that a latent hematoma has formed in a newborn, the cause of which may be generic and postnatal,
- incessant crying
- excessive sleepiness,
- increased activity or inhibition of motor reactions,
- constant regurgitation of milk after each feeding and between them.
With such symptoms do not hope that the problem will pass by itself. You must immediately call a doctor, otherwise you put your child at great risk.
Methods for diagnosing pathological hemorrhages
The causes of hematomas of a newborn can be different and regardless of their origin, it is necessary to detect the development of pathology in a timely manner. If hemorrhages are suspected, diagnostic activities begin with a thorough obstetric examination. Doctors of various qualifications take part in the examination of the baby: an ophthalmologist, a neurosurgeon, a neurologist and others if necessary.
The exact type of education and how to treat hematoma in a newborn, if it is present, is determined by the attending physician only after a comprehensive examination according to the diagnostic results. The diagnostic procedures include the following:
- blood test for the presence of platelets and determination of the coagulability coefficient,
- In order to clarify the depth and size of the bruise through the open fontanelles, an ultrasound of the brain is performed,
- depending on where the bruise is located, doctors prescribe CT and MRI of the brain,
- in order to detect damage to the bones of the skull x-rays are performed.
These are the main diagnostic methods, by means of which the hematoma on the head of a newborn is determined or refuted, how the disappearance of the formation takes place depends on its complexity and timely treatment.
Therapeutic care for hematomas in children
In most cases, intracranial hemorrhages are not dangerous for life and health. Usually this type of formation dissolve independently after 7-14 days after their appearance.
But there are individual cases when hematomas in newborns on their heads do not disappear by themselves, when they pass and how successful the recovery process depends on the complexity of the formations and on the proper treatment performed in time.
Depending on the type and location of the bruising, different drugs can be prescribed as an auxiliary therapy by doctors, the action of which is aimed at accelerating the resorption process of hematomas. Most frequently, Troxevasin gel or Troxerutin ointment is used as a drug. The frequency and dosage of use are prescribed by the attending physician.
When the size of the bruises is large and they contain more than 100 ml of accumulated fluid, then in such cases aspiration will be the best treatment. These are completely safe manipulations and after they are performed as quickly as possible and without harm to the child’s body, the hematoma on the head is completely eliminated. When recovery comes, the child fully develops and no consequences threaten him.
Remember the main thing! Whatever the hematoma on the head of the newborn, without fail it must be shown to a qualified specialist. Typically, these pathologies are still found in the hospital during an obstetrician examining a child. But if you are discharged home and you notice any deterioration in the baby’s well-being, then you should not self-medicate.
The consequences of the hematoma on the head of a newborn, when the pathology passes and how quickly your baby recovers, directly depend on your care and responsibility.
The bruise on the head of a newborn in medicine has a fixed name - “cephalhematoma”. It is a steady accumulation of blood resulting from the rupture of soft tissues. To understand how dangerous this trauma is for a newborn, it is necessary to find out the reasons for the appearance of cephalhematoma. It occurs at the time of passage of the tiny birth canal. The fact is that the pressure inside the womb differs from the outside, for this reason the capillaries and small vessels do not withstand the impact, the integrity of their walls is disturbed.
In the process of labor uncomplicated by other factors, hematomas practically do not arise. As a rule, the action of additional causes leads to injury:
- large head circumference
- abnormal previa (pelvic, buttock, shoulder and others),
- narrow pelvis of the mother
- low water,
- use of obstetric techniques and tools (forceps, vacuum),
With abnormal presentation of the first light, not the head, which in a newborn has a larger volume, but other parts of the body. As a result, the birth canal is not fully disclosed. With shallow water, the child is more difficult to pass through the birth canal, as they are almost dry.
Symptoms and features
Externally, hematoma is not a classic bruise. It looks like a small lump, inside which, when pressed, the liquid rolls. Additionally, you can see single hemorrhages in the form of points on the surface of the skin. You shouldn’t put pressure on it yourself, since the newborn has very fragile cranial bones, and also has a spring.
During the first three days of life in infants, the hematoma grows, because of the reduced blood clotting, fluid builds up in it. Reduction of cefalohematoma can be seen only a week after the birth of the crumbs. Finally it resolves to 3-8 weeks of life.
Doctors believe that this hematoma should not be a sign of concern. It is only important to be able to distinguish it from the generic tumor:
- Cefalohematoma is located only on one bone of the skull, while the tumor may cover several.
- The tumor has a higher density, there is no overflowing fluid.
- The tumor appears on the part of the body that was closer at the time of birth. Its localization depends on the presentation.
- A generic tumor resolves faster, it does not have hemorrhages inside. It appears for the same reasons as cephalhematoma.
The effects and nature of these two injuries are different. Cefalohematoma is more stable, it takes much longer.
Any birth injury can lead to complications. Parents should worry only if the infant has the following symptoms:
- there are problems with feeding (weak breast grip, regurgitation, refusal of food),
- anxiety, agitation, sleep problems,
- the uneven shape of the head, the crumb it often tilts in one direction or tilts,
- tearing from one eye,
- muscle hypotonia
With such signs it is necessary to turn to a pediatrician and a neurologist. Birth trauma can cause mental or mental retardation. physical development. In rare cases, in the presence of other provoking factors, it causes cerebral palsy.
More frequent effects of cefalohematoma:
- anemia due to heavy blood loss
- ossification (you will notice that it hardened),
- physiological jaundice.
If serious violations after an injury are suspected, your pediatrician will order additional tests for you to make an accurate diagnosis. This may be an MRI, CT scan, ultrasound of the head. Additionally, the doctor will need to monitor the performance of blood tests.
In most cases, when the hematoma is absorbed independently, treatment is not indicated. A set of measures is prescribed for its strong growth, the development of complications. To get rid of cefalohematoma will help one of two methods:
- Increased blood clotting by taking vitamin K and calcium gluconate. These drugs will help to stop the bleeding, and accordingly, the growth of the tumor. They are prescribed if, as a result of a blood test, the newborn began to develop anemia.
- With a large amount of hematoma (from 8 centimeters), a puncture is performed.
An alternative, but not yet common method is laser removal of hemorrhage. In this case, a tight bandage is applied to the head of the child, preventing infection of the wound. At suppuration, the cefalohematoma is opened, drains are established, and an antiseptic dressing is applied.
What is it and for what reasons?
A hematoma on the head of a newborn or other part of the body is a type of birth trauma in which soft and hard tissues are damaged. By itself, the hematoma is a tumor - the result of a rupture of blood vessels during trauma to the internal organs.
There are varying degrees of severity and intensity of injuries at birth. Many of them resolve themselves 2-4 weeks after birth without medical intervention, while others require the supervision of specialists.
The main causes of hematomas on the baby’s head after birth:
- Squeezing the head or other part of the body at birth. The cranial bones of the baby are still flexible (to facilitate passage through the narrow birth canal). Since at the birth of the child the head comes out first, it is squeezed, especially when the pelvis is narrow or the head circumference is too large.
- Different pressure in the womb and outside the maternal organism. The consequence of sudden pressure drops on the appearance of light can be a rupture of blood vessels and hemorrhage. This is observed at cesarean section or hardware extraction of the fetus.
Possible causes of hematoma in a newborn:
- mistakes of health workers during childbirth,
- wrong actions of the woman in labor,
- large fruit (over 4 kg),
- weak labor activity
- child prematurity
- hypoxia or asphyxia
- cord entanglement
- childbirth at week 41-42, when the bones lose their elasticity,
- hydrocephalus, when fluid accumulates in the fetal brain,
- prolonged labor,
- the woman belongs to the old-aged,
- the woman has a history of fractures or damage to the pelvic bones, abortions or miscarriages,
- multiple pregnancy,
- fetal extraction using a vacuum extractor and other devices.
How does it look and where is it located?
Hematoma can be met in 1-2% of newborns. The most frequent place of its formation is the head. Places of localization on the head:
- back of the head
- front end,
- lateral area.
The formation of hematomas occurs as a result of blood accumulation. The size of the tumor depends on its quantity. With a large volume (over 150 ml) of accumulated blood, the problem is most often solved surgically. However, the tumor does not acquire its parameters immediately. The fluid accumulates gradually, and the hematoma grows to its maximum size in a few days. Reduction of education is observed after 7-10 days. Full resorption occurs at 3-8 weeks of life of the baby.
Despite the fact that such hemorrhage has a lot in common in the mechanisms of formation with a bruise, externally, the hematoma is absolutely not like a bruise. The skin of the affected area remains unchanged. Only a detailed examination can detect small points of hemorrhage.
Symptoms and diagnostic methods
The symptomatology of hemorrhages is shown to the greatest degree approximately for the third day after the birth. By this time, generic tumors usually subside, and a small lump remains.
Other symptoms of hematoma:
- Swelling. By clicking on this loose formation, you can feel the presence of fluid.
- Head asymmetry. Puffiness acquires clear boundaries.
- Minor hemorrhages. They are small red dots located in the area of the pathological process.
- Cyanosis of the skin, which gives the child an unhealthy look.
- Pronounced pain syndrome with pressure.
- enlarged pupils,
- poor appetite
- frequent regurgitation in newborns.
There are more severe symptoms characteristic of intracranial hematomas:
To diagnose hemorrhage can only be a doctor. For an accurate diagnosis will require:
- Visual inspection. The doctor determines the clinical picture of education.
- Blood test. Shows the number of platelets and the degree of clotting.
- Ultrasound. It is necessary to determine the size, depth and location of hematoma. You can identify a brain hernia.
- MRI or CT scan. Это дополнительный метод диагностики, который назначается в зависимости от локализации гематомы.
- Рентгеновское исследование. Allows you to determine the presence of damage to the bones.
Is treatment required?
Usually, such formations are resolved independently and do not require special treatment. However, a child with hemorrhage must necessarily be under medical supervision to make an accurate diagnosis and establish the causes of hematoma - whether it is a consequence of a blow, injury during childbirth, incorrect manipulations and what the danger is. If such formations do not pass themselves after 2 weeks, or there is no positive trend in reducing their size, the help of specialists is shown.
If the formation is large or does not take a long time, puncture is required. The surgeon performs the manipulation with the help of special needles. It removes accumulated fluid and blood clots.
A second puncture is also done to prevent pressure drops. This procedure is painless and harmless. After all the manipulations, a pressure bandage is applied. It needs to be changed within 10 days. It is important during this period not to rock the baby. Motion sickness causes an increase in intracranial pressure.
If the hematoma is small and there are no other pathological processes, the puncture is optional. Enough to drink a course of medicine for 3-5 days. The number of prescribed drugs include: calcium gluconate, which is administered intravenously, vitamin K in liquid form. This treatment is carried out in the hospital.
It is important to allow further development of the process. In 80% of cases, hematomas pass completely, without provoking negative consequences and complications, but the risk of their occurrence still exists.
Without timely treatment or with improper therapy, the following complications are possible:
- Unaesthetic appearance. The hematoma becomes stiff, leaving a lump on the head, the shape of the head changes.
- Delays in physical and mental development.
- Cerebral palsy.
- Anemia or anemia. The production of hemoglobin decreases and the process of transporting oxygen to organs and tissues is disturbed.
- Jaundice is the result of accumulation of bilirubin in the surrounding tissues and its entry into the bloodstream. Characteristic symptoms of jaundice - the acquisition of a yellow hue by the skin and eye sclera.
- Tumor suppuration. In the hematoma pus accumulates, which complicates the treatment.
Hematoma in the running form makes it difficult for the baby. He has difficulty eating, becoming moody. High nervous excitability adversely affects the functioning of the central nervous system.
What is it and its etiology
Hematoma is a hemorrhage that occurs as a result of physical impact on the blood vessels. There are many factors that influence the appearance of hemorrhages in babies after birth. Conventionally, they can be divided into the main causes of the formation of hematomas and those that increase the likelihood of their formation.
Hematomas on the head appear due to:
- Compression during the passage of the child through the birth canal of a woman.
- The pressure drop that occurs at birth. When a child is in the womb, one pressure affects him, and when another is born.
Factors that increase the likelihood of complications:
- The discrepancy between the size of the head of the fetus and the birth canal of the mother.
- The use of obstetric benefits.
- Abnormal presentation of the fetus (pelvic, buttock, foot, oblique).
- Insufficient amniotic fluid, which increases birth injuries.
- Deliveries whose duration is less than 2.5 hours and more than 1 day.
- With the pathology of the development of the umbilical cord, which provokes the risk of injury.
The further mental and physical development of the child depends on the type of hematoma. They are usually divided into:
- Intracerebral hematoma is characterized by the presence of hemorrhages in the brain.
- Subdural hematoma forms under the dura mater.
- Epidural hematoma is one of the most complex and most dangerous for the life of the newborn. When it occurs, the blood vessels rupture in the area between the bones of the skull and the dura mater.
- Cefalohematoma is a consequence of the ingress of blood between the ankle and the skull bones.
A generic tumor is not a disease. It does not affect the general well-being of the child and passes on its own without consequences and treatment. The tumor is a swelling of the soft tissues of the head, which has no clear boundaries. For a generic tumor, localization at the lowest point (crown, occiput) is characteristic as it passes through the birth canal of the mother.
Subaponeurotic hematoma of the brain in newborns is a very common complication during childbirth, especially if obstetric forceps and a vacuum extractor are used. It is located between the bones of the skull and the muscles that cover the scalp. A subaponeurotic hematoma looks like a small saccular area that is soaked in blood. If these formations are of small size, then it can take about 7 days to self-resorb them.
And larger ones can be very dangerous for the health of newborns in the form of hypovolemic shock, anemia and infection in the area of traumatic exposure.
With periosteal stasis, damage to the skull's epithelium. First, the vessels dilate, and then burst and the surrounding tissues are soaked in blood. Periosteal stagnation has clear boundaries and looks very similar to a bruise.
If during childbirth a stronger effect occurred on the baby’s head, then cephalohematoma is formed. Swelling occurs in places of impact. The skin above it without features. With a more detailed examination, you can detect small point hemorrhages. Hematoma in infants visually is a small bag of fluid with clear contours. After some time, its center softens, and the boundaries harden opposite.
Treatment of cefalohematoma should be approached very seriously since it can very often lead to various kinds of complications. In addition, cefalohematoma may be accompanied by fractures of the bones of the skull.
With a light course of cefalohematoma can stretch themselves. In cases with more extensive lesions, hematoma may undergo ossification or, in other words, replacement of blood with bone tissue.
Normally, the hematoma of the brain in a newborn must pass on its own in 10-14 days. In evaluating the process, the size of the bruise must be considered. Favorable resorption and reduction of hematoma size are considered to be a favorable outcome of the traumatic impact. For all this time, the child does not feel any discomfort. To clarify the diagnosis and obtain more detailed information in the postpartum period, ultrasound, X-ray, magnetic resonance therapy and computed tomography are performed. Treat hematomas after 10 days from birth.
When parents need to see a doctor immediately
Often hematomas do not have any serious influence on the further life and development of the child. However, everyone is well aware that a hematoma is caused by trauma, which can lead to serious consequences. Next, we will talk about the symptoms, the appearance of which should immediately seek help from a pediatrician and a neurologist:
- Problems with food intake, due to the fact that the newborn eats very badly, spits up large volumes.
- The child is excessively excited or, on the contrary, very calm. In a dream, trembling and twitching of limbs can be observed.
- The kid can not normally hold his head, constantly rejects it in one direction or throws it back.
- Insufficient muscle tone.
If the above symptoms appear, it is best to consult a doctor because these symptoms may indicate a disturbance in the nervous system, which can lead to mental and physical retardation.
Treatments aimed at eliminating hematoma
If complications arise or the hematoma does not go away 2 weeks after delivery, the treatment is performed surgically. It is aimed at aspirating the hematoma. For the procedure, the doctor takes 2 needles. One is necessary in order to do aspiration of blood, and the second to prevent negative pressure. After the procedure, the child is prescribed calcium gluconate and vitamin K.
Therapy of cefalohematoma after childbirth
Since cefalohematoma on the baby’s head after birth is most common, methods for its removal should be considered. If the cephalohematoma has not resolved itself, the puncture of the newborn is carried out, when with the help of two special needles the doctor pumps out all the liquid from the lump.
One needle is used for pumping blood, while the other is regulated by pressure in order to avoid its drop. Such a surgical procedure is carried out safely for the health of the baby and painlessly, since a local anesthetic is used.
Be that as it may, puncture is the most effective therapy in eliminating cephaltohematoma. If cefalohematoma is large, then after surgery a drug treatment is prescribed.
Children with poor blood clotting, the doctor prescribes hemostatic drugs. It is desirable that the newborn before the final recovery received breast milk.
It is with mother's milk that all necessary substances enter the baby’s body, strengthening it and preventing infection and suppuration.
Another common consequence of birth injury is the formation of a subperiosteal accumulation of blood.
In this case, uncoagulated blood (newborns lack their own coagulation factors) accumulates between the periosteum (the connective tissue structure covering the bone and feeding it) and the underlying bone of the skull.
The most common localization of cephalhematoma is the parietal region. Less often - occipital, frontal, temporal cephalhematomas.
Cephalohematoma in newborns is called hemorrhage, which is formed due to the compression of its head during the passage of the birth canal. In places that have been strongly pressed against the birth canal, a bruise is formed. The vessels and capillaries are broken, blood flows into the space between the periosteum (the tissue that lines the bones of the head) and the cranial bones. The surface of the skin remains unchanged, even the color remains, but point spots of blood (hemorrhages) on the surface of the head indicate cephalohematoma.