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Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Cephalhaematoma is an effusion of blood (haematoma, bruise) under the periosteum that covers the skull. It can occur during vaginal birth when there is friction between the fetal skull and the maternal pelvic bones, but is most commonly associated with instrumental delivery, especially ventouse extraction. It affects between 1 and 12 in 100 babies. More than one bone of the skull may be affected, causing multiple haematomas. Unlike caput succedaneum, it is not apparent at birth but appears after 12 hours. The swelling grows larger over subsequent days and can persist for weeks. The swelling:

  • Is circumscribed and firm
  • Does not pit on pressure
  • Does not cross a suture
  • Is fixed

No treatment is necessary and the swelling subsides when the blood is reabsorbed. Erythrocyte breakdown in the extravasated blood may result in hyperbilirubinaemia (jaundice).


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