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• W2335415623 abstract "A 1-day-old girl presents with bilateral pedal edema at birth (Fig 1). She was born at 37 weeks’ gestation to a 29-year-old now gravida 5, para 3 mother who received poor prenatal care. The mother's blood type is O Rh+, she is rubella immune, and the results of serologic testing are negative for hepatitis surface antigen, syphilis, and human immunodeficiency. Pregnancy was complicated by pancreatitis, and the infant was born via repeat cesarean delivery complicated by late decelerations. Her Apgar scores were 7 and 9 at 1 and 5 minutes, respectively.Figure 1. Pedal edema.On presentation to the nursery, the infant appears in no apparent distress, is alert, and has a weight of 3,020 g (20th percentile), a length of 46 cm (25th percentile), a chest circumference of 34 cm (>90th percentile), and a head circumference of 33 cm (50th percentile). Examination of the head is significant for posteriorly rotated auricles and high-arched palate. There are no abnormal pulmonary or cardiovascular findings. Her abdomen is soft and round, with active bowel sounds and no organomegaly. Musculoskeletal examination shows bilateral edema to the feet with normal capillary refill and positive femoral and pedal pulses. The infant also has bilateral hypoplastic toenails (Fig 2).Figure 2. Congenital lymphedema with puffiness over the dorsum of the feet and toes; narrow deep-set nails.Laboratory results include the following: white blood cell count, 7.2×103/μL; hemoglobin, 16.9 g/dL; hematocrit, 48%; platelet count, 177×103/μL; blood type, B+; direct antiglobulin test, positive; unconjugated bilirubin, 6.1 mg/dL; and reticulocyte count, 5.2%. One additional test reveals the cause of the pedal edema.Cardiac echocardiography was performed and revealed a secundum atrial septal defect with an otherwise normal intracardiac anatomy. In addition, a renal ultrasound was ordered, which did not display any abnormalities. The results of her first newborn …" @default.
• W2335415623 created "2016-06-24" @default.
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• W2335415623 date "2011-12-31" @default.
• W2335415623 modified "2023-10-16" @default.
• W2335415623 title "Index of Suspicion in the NurseryCase 1: Bilateral Pedal Edema in a NewbornCase 2: Early-Onset Conjugated Hyperbilirubinemia in a Preterm Infant" @default.
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• W2335415623 doi "https://doi.org/10.1542/neo.13-1-e49" @default.
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