• Dr Peter Chew


I am 29 and a first-time mum. I had a bad and traumatic experience during my delivery. My labour lasted more than 16 hours. The obstetrician had to use a “vacuum’ cup to extract my baby after I was exhausted trying to push my baby out for more than 2 hours. My baby weighed 3.7 kg. He had a large swelling over his head. The paediatrician told me that he had a cephalohematoma which would take a while to subside. What is Cephalohematoma? Will it have any effect on my baby’s health?

A cephalohaematoma is an accumulation of blood clot in the space between your baby’s scalp and his skull bone. It is the result of bleeding from scalp’s blood vessels due to compression between the foetal head and the pelvic bones in prolonged labour. The injury is further aggravated by assisted deliveries using forceps or vacuum extractor. If the amount of bleeding is little, the swelling is small and soft. Otherwise, it is firm and hard. It happens more often in the first -time mum and the risk is increased with bigger baby.

Cephalohematoma is associated with some medical problems. They include:

· Skull fracture: Cephalohematoma may be a sign of an underlying skull fracture, particularly if forceps or vacuum are used during delivery. The baby must be closely monitored as developmental delays may occur later.

· Jaundice: The clots in cephalohematoma may disintegrate and release the yellow pigment (bilirubin) into the blood stream causing jaundice in the baby. The jaundice may be severe if the cephalohematoma is big. The bilirubin released may result in brain damage and cerebral palsy (a form of childhood movement disorder).

· Infection: If the clots get infected, the skull bone and the brain will be affected with serious consequences.

· Anaemia: If the bleeding is severe, the baby may become anaemic, fatigued, weak, and uninterested in feeding.

Your baby will be monitored by your paediatrician closely and appropriate treatment will be given if complications arise.

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