Chignon (medical term)

For the hair pattern, see Chignon (hairstyle).
Chignon
A baby's scalp showing the effects of a vacuum extraction.
SpecialtyPediatrics

A chignon (an artificially induced caput succedaneum) is a temporary swelling caused by a build-up of bloody fluid left on an infant's head after they have been delivered by vacuum extraction. A vacuum extraction is a type of assistance used during vaginal delivery by an obstetrician or midwife when the second stage of labor, where the cervix is fully dilated allowing for fetus delivery, is stalled.[1][2][3][4][5] It anatomically resembles regular caput succedaneum, one of two most frequently occurring birth injuries to the head, the other being cephalohematoma, a usually harmless condition where blood accumulates under the newborn's scalp after vaginal delivery.[6][7]

During vacuum extraction, the cup is attached to the infant's head, exposing the infant to trauma due to the vacuum pressure and pulling force involved in the procedure.[6] This form of assisted delivery is typically required when the labor is stalled due to difficulties in the stages of labor arising, such as when the infant's head found too high in the birth canal. Due to prolonged pressure and tension, this induces an accumulation of interstitial fluid (the fluid that surrounds cells) as well as possible minor hemorrhages, ultimately resulting in scalp swelling.[8][9]

A chignon should not be mistaken for bruises or other similar fetal head traumas relating to vacuum extraction.[10] It chignon should begin to resolve within an hour, but it may take between 12 and 18 hours to completely disappear.[11][12] There are no long-term consequences for the newborn, but as with all birth traumas, it is recommended to be attended to and monitored.[6][11]

  1. ^ Baston H, Durward H (June 23, 2010). Examination of the Newborn: A Practical Guide. Routledge. pp. 72–75. ISBN 978-0-203-84995-8.
  2. ^ "Bloody Show: Symptoms & Signs of Labor". Cleveland Clinic. Retrieved 2023-08-01.
  3. ^ Hutchison J, Mahdy H, Hutchison J (2023). "Stages of Labor". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 31335010.
  4. ^ "Vacuum Extraction Delivery: What to Expect & Side Effects". Cleveland Clinic.
  5. ^ Goordyal D, Anderson J, Alazmani A, Culmer P (January 2021). "An engineering perspective of vacuum assisted delivery devices in obstetrics: A review". Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 235 (1): 3–16. doi:10.1177/0954411920956467. PMC 7780266. PMID 32928047.
  6. ^ a b c Nicholson L (2007). "Caput succedaneum and cephalohematoma: the cs that leave bumps on the head". Neonatal Network. 26 (5): 277–281. doi:10.1891/0730-0832.26.5.277. PMID 17926657. S2CID 19351510.
  7. ^ "Cephalohematoma Birth Injury: Causes and Complications". Cleveland Clinic.
  8. ^ Stewart RH (2020). "A Modern View of the Interstitial Space in Health and Disease". Frontiers in Veterinary Science. 7: 609583. doi:10.3389/fvets.2020.609583. PMC 7674635. PMID 33251275.
  9. ^ Subgaleal Haemorrhage (SGH) Detection and Management in the Newborn (PDF). Government of Western Australia Child and Adolescent Health Service. 2015.
  10. ^ Vacca A (February 2002). "Vacuum-assisted delivery". Best Practice & Research. Clinical Obstetrics & Gynaecology. 16 (1): 17–30. doi:10.1053/beog.2001.0252. PMID 11866494.
  11. ^ a b Cite error: The named reference NSW Government_2022 was invoked but never defined (see the help page).
  12. ^ McQuivey RW (September 2004). "Vacuum-assisted delivery: a review". The Journal of Maternal-Fetal & Neonatal Medicine. 16 (3): 171–180. doi:10.1080/1476-7050400001706. PMID 15590444.