soft tissue birth injuries - differential diagnois and anatomy

Source: Lissauer & Clayden: Illustrated Textbook of Paediatrics 3E

Differential Diagnosis

• Caput succedaneum - bruising and oedema of the presenting part extending beyond the margins of the skull bones; resolves in a few days.
• Cephalhaematoma  - haematoma from bleeding below the periosteum, confined within the margins of the skull sutures. It usually involves the parietal bone. The centre of the haematoma feels soft. It resolves over several weeks. It is occasionally accompanied by a linear skull fracture.
• Chignon - oedema and bruising from Ventouse delivery.
• Bruising to the face after a face presentation and to the genitalia and buttocks after breech delivery. Preterm infants bruise readily from even mild trauma.
• Abrasions to the skin from scalp electrodes applied during labour or from accidental scalpel incision at caesarean section.
• Forceps marks to face from pressure of blades - transient.
• Subaponeurotic haemorrhage (very uncommon) - diffuse, boggy swelling of scalp, may be accompanied by serious blood loss leading to hypovolaemic shock.

Anatomy