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Birth Injury - Traumatic Vaginal Delivery with Vacuum Extraction and Head Injuries. The fetus is shown during the delivery process with application of the vacuum extractor to the crown of the head. The second illustration shows the external swelling and bruising to the vacuum application site on the back of the head as well as multiple bruises to the infant face. The final illustration features a single cut-section through the brain to show the presence of intraventricular hemorrhage.