baby is 4 day old female  was referred to KATH MBU by mother complaining  of poor feeding and abnormal body features present at birth
Examination :
Not pale , anicteric, CRT<2s, RBS 3.1mmol/l     PCV 60%
HR 98 bpm, HS : S1 + loud pansystolic murmur, not cyanosed,
Lower chest indrawing , grunting RR 40cpm ,fine creps at lung bases
Abd :cord clamped with erythematous  base
Dysmorphic features : Micrognatia (Small chin ), over ridding fingers , bilateral talipes equinovarus( club foot)
Diagnosis :
1 Edwards Syndrome ( Trisomy 18 )
2. Cord sepsis
3. CCF
Investigations :
Echocardiography :
Large VSD (0.8cm) – No gradient  across
Small ASD with Left to Right shunting
Dilated Right ventricle
Conclusion : VSD with right heart overload
Management Plan:
iv lasix 2.2mg
IV antibiotics
Single intranasal O2
NGT feeding of EBM
Results of investiagtions woulf be updated on this case
Credits : All MBU Doctors , KATH, Kumasi
Reading : http://www.nlm.nih.gov/medlineplus/ency/article/001661.htm
Mothers permisssion sought to take and display baby’s image on the site for academic purposes only.