MOULDING

This is a natural phenomenon rather than an injury. Various bones of the skull are not yet united and the skull bones are able to override each other to reduce the diameter of the head, thus facilitating passage through narrow birth canal. Degree of Moulding is assessed by the overriding of the bones. If moulding is absent, the skull bones are felt separately. With slight moulding, the bones just touch, then they override but can be reduced; finally they override so much that they cannot be reduced. Excessive moulding during labor indicates severe disproportion between pelvis and size of the head and can result in intracranial damage.

CEPHALHAEMATOMA

This is a Subperiostial (below the external covering of the bone) swelling on the fetal head and is commonest over parietal bones. It is fluctuant (compressible). Spontaneous absorption occurs but may take weeks and may cause or contribute to neonatal jaundice.

CAPUT SUCCEDANEUM

This is an edematous swelling of the scalp, outside the bones and is the result of venous congestion and exuded serum caused by pressure against the cervix and lower segment during labor. The presenting part of the head therefore has the swelling over it. It gradually disappears in the first days of the birth. When ventouse extraction is used in labor a particularly large caput is formed under the ventouse cup.