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NeoReviews Vol.9 No.8 2008 e353
© 2008 American Academy of Pediatrics

Index of Suspicion in the Nursery

The first 20% of the full text of this article appears below.


   Case Presentation
 
A pair of twins are born at 36 weeks’ gestation to a healthy 43-year-old G2 P1 woman who has a healthy 2-year-old son. Maternal serology revealed blood group B Rh-positive, negative hepatitis B surface antigen, nonreactive venereal disease research laboratory test, rubella immune, and positive group B Streptococcus test. The pregnancy was complicated by diamniotic dichorionic twins and restricted growth in twin A (girl). Cesarean section was performed because of poor interval growth of twin A and a biophysical profile of 4/8. Apgar scores were 8 at 1 minute and 9 at 5 minutes, respectively. Twin B (boy) weighs 3,120 g, and his occipitofrontal circumference is 37 cm. Twin A weighs 1,830 g, and her occipitofrontal circumference is 32 cm.

The girl is admitted to the special care nursery because of low glucose values and poor feeding. She is in an incubator and is otherwise well. The boy is sent to the normal nursery with his mother. Both infants are breastfed, and their courses in the first 24 hours after birth are unremarkable. A complete blood count (CBC) is ordered to evaluate for twin-to-twin transfusion because of the size discordance. Results . . . [Full Text of this Article]

Akshaya Vachharajani, MD
Jill Baer, MD

Washington University School of Medicine in St. Louis and St. Louis Children's Hospital, St. Louis, Mo


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