The pressure (at birth) interferes with blood flow from the area causing a localized edema.
Cephalhematoma is a collection of blood between the periosteum of a skull bone and the bone itself.
The exact cause depends on which form a baby has. Immune hydrops fetalis is a complication of a severe form of Rh incompatibility. It often appears over the vertex of the newborn’s head as a result of pressure against the mother’s cervix during labor.

Rh compatibility causes massive red blood cell destruction, which leads to several problems, including total body swelling. Severe swelling can interfere with how the body organs work. Nonimmune hydrops fetalis occurs when a disease or medical condition disrupts the body's ability to manage fluid. In this case, the caput corresponds to the area where the extractor is used to hasten the second stage of labor. The swelling with cephalhematoma is not present at birth rather it develops within the first 24 to 48 hours after birth.

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