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The Case
A term infant who has a congenital scalp defect.
Prenatal and Birth Histories
A term male infant is born to a 17-year-old gravida 1, para woman through normal vaginal delivery at 37 weeks’ gestational age. The infant cried immediately after birth, and routine care was given. Apgar scores were 9 at both 1 and 5 minutes of age.
Although the mother had received inadequate prenatal care, she had no other medical or surgical problems. Her prenatal laboratory test results included negative HIV rapid plasma reagin and hepatitis B; she was immune to rubella. Her maternal family history was significant for extremity and skin-related malformations, including mother (scalp and foot deformities in small toes in both feet), aunt (scalp defect only), and cousin (foot deformities only).
Because of prolonged premature rupture of membranes, the infant was treated empirically with antibiotics for 72 hours. His hospital course otherwise remained unremarkable.
Physical Examination
Vital signs: temperature, 37°C; heart rate, 140 beats per minute; and respiratory rate, 30 to 40 breaths per minute
General: pink and well-perfused infant is breathing comfortably on room air, …
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