Neonatal scalp swellings can occur due to trauma during childbirth. Risk factors include primigravida mothers, fetal macrosomia, abnormal presentations, and certain birthing interventions. There are three main types of extracranial scalp swellings: caput succedaneum, cephalhaematoma, and subgaleal hemorrhage. Caput succedaneum is a collection of fluid above the periosteum that usually resolves within 3 days. Cephalhaematoma is a subperiosteal blood collection that can take up to 6 weeks to resolve. Subgaleal hemorrhage bleeds into the potential space between the scalp and perioste

1. Neonatal scalp swellings
Dr Thoren Kgaabi

2. • Occurs due to trauma of the extracranial during childbirth
• Ranges from minor to more severe injuries

3. Risk factors
• Maternal
Primigravida
Short stature
Pelvic anomalies
Prolonged or rapid labour
Malposition

4. Risk factors
• Fetal
Macrosomia
abnormal presentation
Macrocephaly
• Iatrogenic
Use vaccum
Use of forceps
Versions and extraction method

5. Extracranial swellings
• Caput succedanum
• Cephalohaematoma
• Subgaleal hemorrhage

6. Ref: Doctorlib

7. Caput succedaneum
• Collection of serous fluid above the periosteum
• Usually associated with soft tissue swellings and bruises
• May cross midline and suture lines
• Usually resolves within 3 days of life and requires no active mx
• Rarely can cause jaundice if bruises are extensive

8. Cephalhaematoma
• Subperiostal blood collection due to rupture of vessels under the
periosteum.
• Predilection to parietal and occipital region.
• No discoloration of the skin
• Does not cross suture lines
• Usually cause significant hyperbilirubinaemia
• Massive haemorhage may cause shock
• Can take up to 6 weeks to resolve

9. Subgaleal hemorrhage (subaponeurotic)
• It develops when emissary veins connecting the dural sinuses and
scalp veins rupture and bleed into potential space between scalp
aponeurosis and periosteum.
• Potential space has a capacity to hold 260mL
• Space not limited by suture lines, can extend to the neck and orbits
• Presents as fluctuant mass that crosses the midline

10. Subgaleal haematoma
• Progresses over 24hours
• Resolves after 2-3 weeks
• Baby might present with pallor, apneas and hypovolemic shock
• Mortality of >25%
• Management involves analgesia, adequate fluid resuscitation, multiple
blood transfusion