Which of the following symptoms may indicate subgaleal hemorrhage in a newborn?

The presence of firm, fluctuant swelling is a key indicator of subgaleal hemorrhage in a newborn. This condition occurs when blood accumulates between the galea aponeurotica (the fibrous tissue over the skull) and the skull itself, often as a result of traumatic delivery. The swelling typically has a characteristic consistency that is both firm and fluctuant, which can be felt upon examination. This specific presentation is critical for healthcare providers to identify, as subgaleal hemorrhage can carry significant risks, including hypovolemic shock and the need for urgent medical intervention.

The other symptoms mentioned are less specific to subgaleal hemorrhage. Fever might suggest infection, while cyanosis indicates inadequate oxygenation, and decreased heart rate could be related to various cardiovascular issues. These symptoms do not provide the same clear indication of subgaleal hemorrhage as the presence of firm, fluctuating swelling does. Recognizing the distinctive swelling associated with this type of hemorrhage is essential for timely diagnosis and management.