Exsanguinating Cephalhaematomata in African Newborn Infants

Abstract

The various types of cephalhaematoma which may occur in the newborn infant are described with special reference to the subaponeurotic variety. The clinical features of exsanguinating cephalhaematoma are described in 10 infants. Nine of these infants had subaponeurotic cephalhaematoma and one infant had a subperiosteal cephalhaematoma. It is emphasized that subaponeurotic cephalhaematoma, which is not uncommon in the African infant, may cause dangerous haemorrhage requiring immediate blood transfusion. It seems that this extensive type of scalp haemorrhage is extremely rare in European infants but the reason for this racial difference is not clear. With the introduction of the vacuum extractor to obstetric practice, it is possible that the incidence of exsanguinating subaponeurotic cephalhaematoma will increase. A possible relation between exsanguinating cephalhaematoma and a disorder in coagulation is postulated. Further investigations are indicated in order to determine this relation more precisely.