ABC of the First Year, 6th Edition (ABC Series) by Bernard Valman, Roslyn Thomas

By Bernard Valman, Roslyn Thomas

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Example text

Failure to pass urine in the first 36 hours or a poor urinary stream suggests posterior urethral valves in a boy. An enlarged bladder may be palpable. 6). Patency of the anus is confirmed by inspection. 6 Ultrasound scan (a) and diagram (b) showing distended bladder and distended posterior urethra due to urethral valves. Genitalia The prepuce or foreskin is attached to the penis at birth and no attempt should be made to retract it. 7). If the urethral meatus is adequate, no immediate treatment is needed, but the infant must not be circumcised and should be referred to a paediatric urologist.

If the hip is dislocated, the dislocation must first be gently reduced and the thigh held in the abducted position while the splint is carefully applied. Potential pressure points may be protected by inserting pieces of cotton wool or similar material. The mother should be told to replace these when they become wet or soiled without disturbing the splint. The infant’s clothes should be put over the splint and not under it. Once the splint is in place, the infant should be washed, weighed and examined without the splint being removed.

7). A flat occiput, poor limb tone and single palmar crease are suggestive but not specific signs. About 2% of normal infants have a single palmar crease in one hand, and prominent epicanthic folds are even more common. Congenital heart disease, most commonly an atrioventricular septal defect, occur in approximately 30% of infants with Down syndrome and will be detected by performing an echocardigram, as a definite murmur may not be present until several weeks after birth. All infants with Down syndrome have developmental delay and slow growth.

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