A Rare Case of Neonatal Death Due to a Cranial Vault Fracture Following the Use of Obstetric Vacuum Extractor and Review of Literature

In the course of childbirth, if complications arise during the expulsion of the fetus, instruments can be employed to facilitate delivery. The vacuum extractor, or ventouse, is considered a relatively safe tool associated with a low rate of complications and mortality. However, it is crucial that the instrument be applied in the correct position and that the pulling force is not excessive to minimize damage to the fetal cranial structures. Fractures of the cranial vault following the application of obstetric vacuum extraction are very rare events. This paper presents a case of perinatal death due to cranial vault fracture and subgaleal hematoma following vacuum extractor application. Only through postmortem examination was it possible to identify incorrect positioning of the ventouse, which was lateralized compared to the recommended position. The misplacement of the device led to an imbalance of forces, causing the cranial vault fracture that led to the infant's demise. A thorough postmortem examination is essential in cases of perinatal death resulting from operative delivery to ascertain the cause of death and reconstruct the dynamics of events during childbirth. In particular, the examination of injuries on the decedent neonate may reveal improper positioning of the instrument.