CAPUT SUCCEDANEUM

 

In prolonged labor, the dependent area of the fetal scalp in immediate contact with the cervix may become edematous. A swelling, known as the caput succedaneum develops (1). The caput may be formed with the fetal head lower in the birth canal, commonly only after the fetal head encounters a rigid vaginal vault (2).
 

ULTRASOUND

 

  • Prenatal detection has been described (1,3).
  • Soft tissue mass overlying the cranium.
  • Overlapping or "moulding" of the sutural bones.
  • Color doppler differentiates it from a vascular hemangioma.

 

 

CT scan on Day 1

 

Notice the large amount of soft tissue swelling overlying the left parietal bone.

 

 

DIFFERENTIAL DIAGNOSIS

 

  • Encephalocele (4).
  • Cephalhematoma - subperiosteal hematoma and does not cross the suture line.
  • Caput succedaneum - focal swelling of the scalp from edematous fluid overlying the scalp and can therefore does cross suture lines.
  • Hemangioma (vascular lesion).

 

PROGNOSIS

 

  • Resolves spontaneously.

 

REFERENCES
  1. Sherer DM, Allen TA, Ghezzi F et.al. Enhanced transvaginal sonographic depiction of caput succedaneum prior to labor. J Ultrasound Med 1994;13:1005-1008.
  2. Cunningham FG, McDonald PC, Gant NF et.al. Mechanism of normal labor in occiput presentation. In: Williams Obstetrics. 19th ed. Norwalk, CT: Appleton and Lange 1993:369.
  3. Schiwmer SR, Lebovic J. In utero sonographic demonstration of a caput succedaneum. J Ultrasound Med 1986;5:711.
  4. Sanders RC. Obstetrics: Fetal head and neck. In: Atlas of Ultrasonographic Artifacts and Variants. 2nd ed. St Louis: Mosby-Year Book 1992:15.