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NeoReviews Vol.7 No.6 2006 e317
© 2006 American Academy of Pediatrics

Index of Suspicion in the Nursery

Prashant K. Sura, MD

Medical College of Wisconsin, Milwaukee, Wisc

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


   Case Presentation
 
A male infant is born at 39 2/7 weeks’ gestation to a 41-year-old G5P2022 woman who had negative findings on prenatal laboratory tests and group B Streptococcus testing. His Apgar scores are 8 and 9 at 1 and 5 minutes, respectively, with points being subtracted for color. He requires no resuscitation. On the first postnatal day, his heart rate decreases to less than 80 beats/min while awake. Clinically, he appears fine and has no cyanosis or respiratory distress.

Findings on physical examination include a temperature of 98.4°F (36.9°C), heart rate of 92 beats/min, respiratory rate of 35 breaths/min, blood pressure of 69/30 mm Hg, and pulse oximetry of 100% on room air. There are no retractions, flaring, or grunting, and breath sounds are equal bilaterally. Cardiac examination reveals regular rate and rhythm, a I/VI systolic murmur throughout the precordium that is loudest at the left lower sternal border, and femoral and brachial pulses that are +2 bilaterally. Tone is normal, and the anterior fontanelle is open and soft.

Further history reveals that the baby had fetal bradycardia in utero with appropriate variability. The mother had been screened for rheumatologic . . . [Full Text of this Article]






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Copyright © 2006 by the American Academy of Pediatrics.