Caput Succedaneum vs Cephalhematoma, Leopold's Maneuvers, Malpresentation and Malposition, Breech😍

Cephalhematoma Vs Caput Succedaneum

Feature	Caput Succedaneum	Cephalhematoma
Collection	Fluid	Blood
Cause	Prolonged stagnation of fetal head during labor	Traumatic instrumental delivery
ㅤ	Due to edema in the layers of scalp	Subperiosteal hemorrhage involving cranial bones
Location	Above periosteum (can cross sutures/ midline)	Below periosteum (cannot cross suture line)
Pits on pressure	Yes	No
Associated with fracture	No	Yes
Appearance	Present at birth in its maximum size	24-48 hours to appear completely
Disappearance	Disappears in 48-72 hours	Take upto 5-7 weeks to disappear Drainage is contraindicated
ㅤ	No neonatal jaundice	Predisposes to neonatal jaundice

Leopold's Maneuvers

• Purpose: Determine fetal position and presentation.

• Order of Grips:
• First 3: Face the patient.
• Fourth: Face the feet of the patient.

First: Fundal Grip

• Hand Placement: On fundus

• Checks For:
• Lie
• Presentation

• Interpretations:
• Empty:
• Transverse lie
• Broad, irregular, soft :
• Buttocks → Cephalic presentation
• Hard, globular:
• Head → Breech presentation

Second: Umbilical/Lateral Grip

• Hand Placement: Lateral side, parallel to umbilicus

• Checks For: Position

• Interpretations:
• Smooth, regular, curved, board-like rigidity: Back
• Small, multiple knob-like structures: Limbs

 

Third: Pawlik's Grip

• Hand Placement: Single hand on pelvic area

• Checks For:
• Presentation
• Engagement of head

• Interpretations:
• Firm, globular, round structure:
• Cephalic presentation
• Can move head side to side:
• Ballotable (not entered pelvis)

Fourth: Deep Pelvic Grip

• Hand Placement:
• Over pelvic area
• Parallel to inguinal ligament

• Checks For:
• Attitude
• Engagement of head
• (Confirms Pawlik grip findings)

• Interpretations:
• Fingers of both hands brought below fetal head
• Both hands:
• Converge: Not engaged
• Diverge: Engaged

Crichton method