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A boy was born after spontaneous labour at 35 weeks’ gestation weighing 2.3 kg (25th centile). Pregnancy had been unremarkable. Labour was not augmented, and spontaneous vaginal (vertex) delivery followed with no instrumentation and no trauma. Apgar scores were 61 and 95, and no significant resuscitation was needed. Progressive occipital swelling was immediately noted. CT head demonstrated extensive comminuted and displaced skull fractures with a large subgaleal bleed (figures 1 and 2). The baby was stabilised with volume …
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