SPONTANEOUS INTRAUTERINE LINEAR SKULL FRACTURE - A RARE COMPLICATION OF SPONTANEOUS VAGINAL DELIVERY

Background: Fetal skull fracture has been reported in conjunction with difficult delivery or extrinsic trauma. Case: We report a case of lin ear, undisplaced, nondepressed skull fracture occurring in a 3540-g ma le infant born at 37 weeks and 4 days' gestation. Linear skull fractur e occurred despite an uncomplicated spontaneous vaginal delivery in th e absence of extrinsic trauma or cephalopelvic disproportion. Subseque nt clinical follow-up 6 years later revealed normal neurologic develop ment without evidence of epileptiform activity or focal neurologic def icit. Conclusion: Linear skull fracture in association with uncomplica ted, spontaneous vaginal delivery is distinctly rare, in contrast to f ocal, congenital molding depressions of the skull. This case demonstra tes that normal spontaneous vaginal delivery without instrumentation o r obvious complication can involve sufficient trauma to result in a li near skull fracture. The precise etiology of these fractures requires further study.