Congenital and Chromosomal Abnormalities Flashcards
If baby has external, internal organs…
soak sterile gauze in saline, cover with bandage/saran wrap
EMERGENT. Transport to hospital
Signs of chromosomal abnormalities
microcephaly
upward slanting eyes
Simian crease
muscular hypotonicity
Signs of congenital anomalies
hydrocephaly microcephaly anencephaly cranioynostosis spina bifida cleft lip
Trisomy 21: Down’s: Signs and Sxs
(1: 7000 births
1: 150 pregnancies)
placid, IQ~50, microcephaly, flattened occiput epicanthal folds, upward slant eyes Brushfield spots (on edges of iris) large protruding tongue without central fissure broad flattened ridge of nose hypotonicity Simian crease Clinodactyly (curved pinky) Heart Dz GI anomaly (eg duodenal atresia) delayed puberty
Trisomy 18: Edward’s: Signs and Sxs
(1:6000 births
95% abort early)
SGA, feeble fetal activity small placenta, 1 umbilical a weak cry hypoplasia of muscle, hopotonia microcephaly, micrognathia low set, malformed ears clenched fist: 2nd and 5th overlap 3rd and 4th~pathognomonic hypoplastic nails, hypoplastic thumb VSD cryptochidism
Trisomy 13: Patau’s Syndrome
1:10,000-20,000
MIDLINE ANOMALIES
microcephaly, sloping forehead
Holoproscencephaly
myelomeningocele
micropthalmia, colobomas (fissures of iris)
capillary hemangiomas on forhead, pos neck
cleft lip/palate
low set, malformed ears
Simian crease
Rocker bottom feet
Dextrocardia, VSD, patent ductus arteriosus
Hydrocephalus
excess CSF in ventricles
caused by obstrution, excess production, impaired absorption
Labs/imaging: dx by Xray/CT; electroencephalogram, screen for infxs dz
TX: Surgical, refer to neurosurgeon
Craniosynostosis
premature fusion of two or more cranial sutures
Holoproscencephaly
failure of forebrain to divide properly
cyclopia, flat nose, single incisor, delayed milestones
Encephalocele
protrusion of brain tissue through suture
Spina bifida
800 mcg folate preconception or prenatally to prevent!
Occulta- dimple or hairy patch
Meningocele- covered by membrane, risk of infection and hydrocephaly. SURGERY
Myocele/Myelomeningocele- dont feed because will need SURGERY. lumbosacral mass, patulous anus (distended/wide open)
Esophageal atresia
polyhydramnios often present
Tracheoesophageal fistula
absence of stomach bubble on US
sxs: drooling, cyanosis, resp distress
Hypertrophic pyloric stenosis
presents at 4-6 weeks
forceful projectile vomiting
pylorus feels like an almond
Meconium plug
sxs: ab distension, vomiting
RFs: diabetic mom, toxemic mom