Caput succedaneum

Definition

Caput succedaneum is swelling of the scalp in a newborn. It is most often brought on by pressure from the uterus or vaginal wall during a head-first (vertex) delivery.

Alternative Names

Caput

Causes, incidence, and risk factors

A caput succedaneum is more likely to form during a prolonged or difficult delivery. This is especially true after the membranes have ruptured, because the amniotic sac is no longer providing a protective cushion for the baby's head. Vacuum extraction can also increase the chances of a caput succedaneum.

A caput succedaneum is sometimes identified by prenatal ultrasound even before labor or delivery begins. It has been found as early as 31 weeks of pregnancy. More often than not, this is associated with either premature rupture of the membranes or too little amniotic fluid (oligohydramnios). All other things being equal, the longer the membranes are intact, the less likely it is that a caput will form.

Symptoms

• Soft, puffy swelling of part of the scalp in a newborn infant
• Swelling may or may not have some degree of discoloration or bruising
• Swelling may extend over the midline of the scalp
• Most often seen on the portion of the head which presented first
• May be associated with increased molding of the head

Signs and tests

A physical examination will confirm that the swelling is a caput succedaneum. No testing is necessary.

Treatment

No treatment is necessary, and it usually heals spontaneously within a few days.

Support Groups

Expectations (prognosis)

Complete recovery can be expected, with the scalp regaining its normal contour.

Complications

Jaundice can result as the bruise breaks down into bilirubin.

Calling your health care provider

This condition is usually noticed immediately after delivery of the child, so no call is necessary -- unless you have additional questions.

Prevention

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References

Mangurten HH. Birth Injuries. In: Fanaroff AA, Martin RJ, eds. Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 27.