International Journal of Case Reports and Images, Vol. 11, 2020. ISSN: 0976-3198 Int J Case Rep Images 2020;11:101179Z01MA2020. www.ijcasereportsandimages.com Akpa et al. 1 CASE REPORT PEER REVIEWED | OPEN ACCESS Fetal vulva laceration during attempted vaginal breech delivery Matthew Abubakar Akpa, Oladele Joshua Alabi, Simon Peterside Onuche Akogu, Temitope Olumide Odi ABSTRACT Introduction: Trauma to the fetal vulva and perineum is an infrequent and life-threatening complication of breech presentation. The objective of this case report is to highlight the possibility of such injury, need for proper training of health personnel, and draw attention to the issue of malpractice and litigation. Case Report: Consent for this study and medical photographs was obtained from the patient. We present a case of a 28-year-old G5P1+3 non-alive patient with one previous Caesarean section who presented with antepartum hemorrhage and breech presentation of the fetus at term. She subsequently had emergency repeat lower segment caesarean section done and a live baby was delivered. Baby was examined and perineal and vulva laceration with vulva hematoma seen. This complication was subsequently managed with good outcome. Conclusion: Trauma to the genitalia and perineum of the fetus though a rare complication of delivery can occur as a result of poor health seeking behavior and lack of skilled birth attendants resulting in malpractice. Health Matthew Abubakar Akpa 1 , Oladele Joshua Alabi 2 , Simon Peterside Onuche Akogu 3 , Temitope Olumide Odi 4 Affiliations: 1 MBBS, FMCOG, MPH Lecturer I Department of Obstetrics and Gynaecology, Prince Abubakar Audu Uni- versity Anyigba, Kogi State, Nigeria; 2 MBBS, MPH, FWACP, Department of Community Medicine, Prince Abubakar Audu University Teaching Hospital, Anyigba, Kogi State, Nigeria; 3 MBBS, FWCOG Senior Lecturer, Department of Obstetrics and Gynaecology, Prince Abubakar Audu University An- yigba, Kogi State, Nigeria; 4 MBBS, FWACS, Department of Paediatric Surgery, Federal Medical Centre, Lokoja, Nigeria. Corresponding Author: Dr. Matthew Abubakar Akpa, MBBS, FMCOG, MPH, Lecturer I, College of Health Sci- ences, Prince Abubakar Audu University, Anyigba, Kogi State, Nigeria; Email: matthewakpa@yahoo.com Received: 25 August 2020 Accepted: 20 October 2020 Published: 19 November 2020 education, community sensitization, adequate training of staff, appropriate staffing, and equipping of hospitals can go a long way to avoid this complication. Keywords: Breech delivery, Malpractice, Perineal abra- sion, Vulva laceration How to cite this article Akpa MA, Alabi OJ, Akogu SPO, Odi TO. Fetal vulva laceration during attempted vaginal breech delivery. Int J Case Rep Images 2020;11:101179Z01MA2020. Article ID: 101179Z01MA2020 ********* doi: 10.5348/101179Z01MA2020CR INTRODUCTION Trauma to the fetal vulva and perineum is an infrequent and life-threatening complication of breech presentation [1, 2]. It can occur during artificial rupture of membrane, assisted breech delivery by untrained staff [3], attempt to manually rotate the fetus from an abnormal position [4] and during caesarean section [1]. Trauma to the perineum is part of a group of injuries that can affect the neonate at birth. These injuries occur with varying frequencies in developed and developing countries with incidence decreasing in developed countries due to improved health care [5]. The incidence in the United States varies from 0.2 to 37 birth traumas per 1000 births [6]. This country has 99% [7] of deliveries being attended to by skilled birth attendants and the caesarean section rate is 31.9% [8]. In Iran, the incidence of birth trauma is 0.2–41.2% per 1000 births [9], while 99% of deliveries are attended by skilled birth attendants [7] and the caesarean section rate is 48% [10]. By contrast, in Nigeria, the incidence of birth trauma ranges between 5.7 per 1000 live births in Maiduguri (with scrotal/vulva injuries forming 6.6% of