Fetal head trauma without maternal uterine injury

Abstract

A pregnant Negro woman, with a predicted delivery date of June 15, 1966, was in an automobile accident. She arrived at Parkland Memorial Hospital unconscious. She regained consciousness promptly, but complained of pain in her right hip. She stated she had not felt fetal movements since the accident. The uterus was enlarged, compatible with a term pregnancy. Pelvic examination revealed fullness in the right pelvis; a cervix dilated 1 em. and not effaced. Th~ fetal head was at -2 station with intact membranes. Fetal heart tones were not heard. X-ray examination of the pelvis demonstrated a fracture of the right acetabulum. A diagnosis of placental abruption was made and labor induced with Pitocin. A stillborn female weighing 6 pounds, 3 ounces was delivered without anesthesia. There were no external signs of trauma seen on the infant. The placenta was normal. Postmortem examination of the child revealed bilateral subgaleal hemorrhages, more on the right. A right parietal skull fracture was found, with a small subdural hematoma underlying it.