Background

Retained fetal head during breech delivery is a rare but serious complication, often exacerbated by undiagnosed fetal hydrocephalus. This condition poses significant risks for both mother and fetus, particularly in settings with limited access to antenatal care.

Case Presentation

A 40-year-old multiparous woman (G7P6A1) at 38 weeks of gestation presented in active labor with no prior prenatal care or ultrasound. She had complete cervical dilation and a breech presentation. Vaginal delivery was attempted but complicated by head retention due to severe fetal hydrocephalus. After failed maneuvers, an emergency cesarean section was performed, extracting a 5 kg stillborn fetus with major hydrocephalus. The procedure was complicated by maternal anemia (Hb 6 g/dL), requiring a blood transfusion.

Discussion

This case emphasizes the importance of antenatal care, including routine ultrasounds, to detect anomalies such as hydrocephalus. The absence of prenatal diagnosis resulted in a delayed cesarean delivery and complications. Prompt surgical intervention and adequate maternal care were essential in managing this emergency.

Conclusion

Undiagnosed fetal hydrocephalus significantly increases the risk of labor complications, particularly in breech deliveries. Routine antenatal imaging and emergency obstetric preparedness are vital to reducing maternal and fetal morbidity, especially in resource-limited settings.