Smith's Recognizable Patterns of Human Deformation

Transverse Lie Deformation

KEY POINTS Transverse lie is the second most common nonvertex presentation during delivery, occurring in 1.2–3 per 100 deliveries. Multiparity, prematurity, placenta previa, polyhydramnios, uterine anomalies, and uterine myomas are associated with transverse lie. Laxity of abdominal musculature in multiparous…

Breech Presentation Deformation

KEY POINTS Breech presentation is considered normal in premature fetuses before 32 weeks of gestation but is responsible for one-third of all deformations in term newborns. Factors leading to breech presentation include prematurity, twinning, chronic amniotic fluid leakage, uterine malformations,…

Wormian Bones

KEY POINTS Wormian bones are accessory bones found within cranial suture lines that vary in size and quantity, with few and small bones being common and many large bones being extremely rare. A majority of children with an excessive number…

Cephalohematoma

KEY POINTS Cephalohematoma is a subperiosteal extracranial hemorrhage often from an injury to the cranial periosteum during labor or a traumatic delivery. Risk factors include vacuum extraction, forceps delivery, fetal scalp monitors, instrumentation, and increased birth weight. Complications of cephalohematoma…

Parietal Foramina

KEY POINTS Parietal foramina are symmetric oval calvarial defects located near the parietal eminences, separated by a narrow bridge of bone. Diagnosis is aided by palpation, radiography, antenatal sonography, and magnetic resonance imaging. Parietal foramina can occur in isolation or…

Anterior Fontanel Bone

KEY POINTS The anterior fontanel on rare occasions ossifies and forms a bony plate. An anterior frontal bone can be seen in normal infants as a variant or in association with craniosynostosis. The anterior fontanelle is an integral part of…

Vertex Craniotabes

KEY POINTS Vertex craniotabes is characterized by diminished mineralization in the superior portions of the parietal bones, caused by prolonged forceful pressure on vertex during birth. The affected region of the calvarium feels soft to palpation and may exhibit a…

Vertex Birth Molding

KEY POINTS Vertex birth molding is the bony adjustments within the cranial vault and soft tissue swelling due to external fetal head compression during delivery. Factors such as fetal head position and size, gestational age, maternal pelvic shape, and uterine…

Multiple Sutural Craniosynostosis

KEY POINTS Multiple sutural synostosis can result from a profound degree of prenatal head constraint or genetic mutations in genes associated with a syndromic form of craniosynostosis. Differential diagnosis is important considering the natural history and prognosis of different syndromes.…