Intrauterine spontaneous depression of fetal skull: a case report and review of literature.

Intrauterine depression of fetal skull, with or without fracture, unassociated with any known trauma during pregnancy or delivery, is extremely rare in Western countries though not so rare in Africa among African women. Usually fetal skull depression is caused by forceps or digital pressure of the obstetrician during manual rotation. Forty such cases are reported in the literature-nine in Western countries and the remaining 31 over a period of three years at Harare Hospital Maternity Centre, Salisbury, Rhodesia, Africa. There, an incidence of one in 4,000 deliveries was observed among the African women but none in 6,000 deliveries of European women during the same period at a nearby hospital. The presentation of this paper is made in view of the rarity of intrauterine spontaneous fetal skull depression in Western countries and the not so infrequent occurrence in African and possibly other developing countries and because of the persistent controversy about the treatment of this condition.