Spontaneous intrauterine linear skull fracture: a rare complication of spontaneous vaginal delivery.

Abstract

Fetal skull fracture has been reported in conjunction with difficult delivery or extrinsic trauma. We report a case of linear, undisplaced, nondepressed skull fracture occurring in a 3540-g male infant born at 37 weeks and 4 days' gestation. Linear skull fracture occurred despite an uncomplicated spontaneous vaginal delivery in the absence of extrinsic trauma or cephalopelvic disproportion. Subsequent clinical follow-up 6 years later revealed normal neurological development without evidence of epileptiform activity or focal neurologic deficit. Linear skull fracture in association with uncomplicated, spontaneous vaginal delivery is distinctly rare, in contrast to focal, congenital molding depressions of the skull. This case demonstrates that normal spontaneous vaginal delivery without instrumentation or obvious complication can involve sufficient trauma to result in a linear skull fracture. The precise etiology of these fractures requires further study.