From the Research
Caput and moulding are physical changes that occur to a baby's head during vaginal delivery, with caput succedaneum being swelling of the soft tissues of the baby's scalp and moulding referring to the temporary overlap of the bones of the baby's skull to allow the head to pass through the birth canal. According to the most recent study 1, the presence of moulding showed a strong association with clinical misdiagnosis, adjusted OR 5.81 (95% CI 1.95-17.30), highlighting the importance of accurate assessment of fetal head position during labor. Some key points to consider include:
- Caput succedaneum typically appears as a soft, puffy area on the part of the head that first enters the birth canal, crosses suture lines, and usually resolves within a few days after birth without treatment.
- Moulding is characterized by ridges along the suture lines where skull bones overlap, and gradually resolves over days to weeks as the skull returns to its normal shape.
- Both caput and moulding are normal physiological responses to vaginal birth and help facilitate delivery, though excessive moulding may indicate cephalopelvic disproportion or prolonged labor.
- The study by 2 used a finite element model to simulate fetal head molding during labor, demonstrating the importance of focusing on fetal injuries with non-invasive methods to anticipate complications during labor.
- Another study 3 presented a non-linear model of the deformation of a complete fetal skull, when subjected to pressures exerted by the cervix, during the first stage of labour, showing good agreement with clinical experiments on the quantitative assessment of fetal head moulding. However, the most recent and highest quality study 1 provides the most relevant information for clinical practice, highlighting the importance of accurate assessment of fetal head position and the association between moulding and clinical misdiagnosis.