Locking and Reverse Molding of the Fetal Skull

Abstract

In 1972 Emery described a condition that he called “locking and reverse moulding of the fetal skull.” Crossing and fixation (locking) of the fetal cranial bones prevented normal skull molding, thus giving rise to pressure on the basal structures of the brain. We describe 7 such cases and compared them with the 9 reported by Emery. Multiple hemorrhages were found, frequently at the base of the brain. All pregnancies had gone near or to term. Most mothers were primiparous and labor was often complicated. In several of our cases there was clinical evidence for cephalopelvic disproportion. The babies had normal birth weights and lengths and died during labor or within 48 h after birth. At autopsy, in a number of instances, other traumatic lesions were found. Clinical history and autopsy findings point to an acute condition, and in most cases there were no other findings acceptable as “cause of death.”

Key Words:

• skull locking
• brain trauma
• fetal death
• molding