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Article
January 1994

Radiological Case of the Month

Author Affiliations

Contributed from the Departments of Pediatrics (Dr Ilagan), Neonatology (Drs Weyhing and Womack), and Radiology (Dr Liang), Wayne State University, Grace Hospital, Detroit, Mich.

Arch Pediatr Adolesc Med. 1994;148(1):65-66. doi:10.1001/archpedi.1994.02170010067015
Abstract

A4020-g BLACK female was born to a 32-year-old, gravida 2, para 0, aborta 1 mother in a vacuum-assisted vaginal delivery after oxytocin was administered. Before delivery, manual rotation of the fetal head from the left occiput posterior position to the left occiput anterior position was performed. At 8 to 9 cm of cervical dilatation, the fetus had prolonged bradycardia leading to vacuum application. Apgar scores were 7/9 at 1 and 5 minutes.

Physical examination demonstrated a pale infant with a discolored, fluctuant mass over the right occipitoparietal area. The neonate was found to have a pulse of 160 beats per minute, respirations of 60 per minute, and a blood pressure of 54/32 mm Hg. Laboratory evaluation showed a hemoglobin level of 114 g/L, a hematocrit of 0.32, and a platelet count of 1.67×109/L. The infant received phytonadione.

In the first hours of life, the indurated area involved the

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