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NeoReviews Vol.8 No.11 2007 e491
© 2007 American Academy of Pediatrics

Index of Suspicion in the Nursery

The first 300 words of the full text of this article appear below.


   Case Presentation
 
A female neonate born at 40 weeks’ gestation presents with failure to void for 48 hours. The mother is an 18-year-old primiparous female who had no significant past medical history or pregnancy complications. Results of prenatal blood tests and ultrasonographic screenings were unremarkable. Maternal screening documented B-positive blood type, rubella immune, negative syphilis screen, negative hepatitis B surface antigen, and positive group B streptococcal screen with adequate treatment during the antepartum period. The infant was delivered via spontaneous vaginal delivery with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. The infant was transferred to the newborn nursery for routine newborn care.

Initial vital signs in the newborn nursery were:

Her initial glucose measurement was 47 mg/dL (2.6 mmol/L). Other than macrosomia, her initial physical examination findings were within normal limits, including normal results of a head, eyes, ears, nose, and throat examination. The lungs were clear to auscultation. Cardiac examination revealed a regular rate and rhythm without murmurs. The abdomen was soft, with normal, active bowel sounds and no palpable masses. Genitourinary examination revealed normal external female genitalia and a normal-appearing urethral opening. The back and anal examinations revealed no pits, hair tufts, dimples, or vertebral anomalies. The infant had normal proximal and distal tone, with normal primitive and deep tendon reflexes.

She did well throughout her first postnatal day, with her vital signs remaining within normal limits and her glucose values ranging from 59 to 67 mg/dL (3.3 to 3.7 mmol/L). She breastfed well every 2 to 3 hours and passed five meconium stools within her . . . [Full Text of this Article]

Maria N. Kelly, MD, FAAP
Robert S. Hoki, MD

College of Medicine, University of Florida, Gainesville, Fla


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Copyright © 2007 by the American Academy of Pediatrics.