Head-On Impact: A Rare Case of Cephalohematoma in Utero

Cephalohematomas are commonly observed in neonates following prolonged or difficult vaginal deliveries, though their incidence is significantly lower in uncomplicated vaginal births and virtually absent in cesarean sections. Cephalohematomas originating in utero before the onset of labor are exceedingly rare. This case report describes such an incident in a neonate after maternal trauma resulting from a motor vehicle accident (MVA), with in utero findings of persistent fetal tachycardia and non-reassuring fetal heart tones. An immediate cesarean section was performed, and the neonate was managed in the NICU for acute respiratory distress, diagnosed with both a subdural hematoma and a cephalohematoma. A comprehensive literature review was conducted using multiple databases, including UpToDate, DynaMed, PubMed, and Google Scholar, employing search terms such as "Cephalohematoma in Utero," "Cephalohematoma from Trauma," and "Cephalohematoma with Subdural Hematoma." Relevant studies were assessed to contextualize this case. The review underscores that while fetal head trauma is rare, it remains a plausible consequence of maternal trauma. Early recognition and vigilant monitoring are critical for optimal management with the potential for full recovery. This case emphasizes the need for clinicians to consider fetal head trauma in the context of maternal trauma, enabling timely interventions and reducing the risk of neonatal morbidity.