Which scalp swelling crosses the suture lines?

• A. Molding.
• B. Cephalohematoma.
• C. Caput succedaneum.
• D. Bulging fontanel.

Answer: (C)

Caput succedaneum is diffuse swelling of the scalp’s soft tissues caused by pressure during labor. Because the edema sits in the superficial tissues above the periosteum, it can spread across the scalp and cross suture lines, not confined to a single bone. This swelling is typically present at birth and resolves within about 24 to 48 hours.

Cephalohematoma, on the other hand, is a subperiosteal bleed beneath a single skull bone. The periosteum confines it to the bone and it does not cross sutures, and it may take longer to resolve.

Bulging fontanel is not a scalp swelling; it’s the fontanelle protruding due to factors like crying or increased intracranial pressure, so it doesn’t describe a diffuse scalp edema crossing sutures.

Molding refers to temporary overlapping of cranial bones along the sutures as the head navigates the birth canal, causing a change in head shape rather than a diffuse scalp swelling. It doesn’t present as a cross-suture edema.

Therefore, the swelling that crosses suture lines is caput succedaneum.