Nikki reports that Dr Upledger calls cephalhematomas after VE, brain
hickeys.  Does he refer to them this way if they arise spontaneously?
Almost none of the cephalhematomas I see are results of instrumental trauma,
but from rapid spontaneous birth when there are ruptured membranes.
Membranes rupture spontaneously most of the time in my hospital, late in
labor.  Should mothers start to feel bad that their bodies were so
incredibly efficient that the baby's sutures didn't have time to glide over
each other evenly, because it allegedly deforms their brains?  I'd really
like to see some evidence for Upledger's claim that the brain is somehow
sucked into the hematoma area.
A cephalhematoma is a bleed on the outside of the skull, between bone and
the periosteal membrane.  That is why they always stay within the bounds of
cranial sutures, and why they take a few days to develop.  There is only a
potential space between bone and membrane, and it takes time for the blood
to force the membrane away from the bone.  OTOH Caput succedaneum (I think
it's spelled that way) is generalized edema of the scalp distal to the
constriction of the cervix, and crosses sutures, but does not involve
bleeding, and it is usually seen after long first stages, being most marked
at birth and subsiding over the first few days.  Since intervention for
being too slow to get born is so frequent in the West, I imagine many young
people in practice now might never see it.
Bleeding INSIDE the skull can be life threatening.  A cephalhematoma is only
life threatening if the baby lacks coagulation factors or is severely anemic
at the outset, so that the blood temporarily out of circulation in the
hematoma has consequences for perfusion of vital organs.  In 20 years, I've
never seen a baby with that kind of sequelae after a VE, but I have seen one
baby who had a subgaleal hematoma following VE, and died of it.

Rachel Myr
Catching up backwards through the archives in Kristiansand, Norway

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