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Healthy Baby Happy Parents
Common Physical Exam Findings
Descent and Delivery Related
The delivery process may result in many different findings. Nearly all resolve over time:
1) Head/scalp - molding of the head, bruising, swelling near the crown (caput succedaneum), abrasions or lacerations, and localized swelling of the head (due to bleeding under the membrane overlying a boney plate (cephalohematoma).
2) Face - drooping eyelids or lips (facial nerve palsy), flattened nose, and crumpled ears all caused by compression.
3) Broken clavicle - The shoulders are the broadest part that must descend through the birth canal. In rare instances, the clavicle breaks to allow for the shoulders and baby to exit without serious problems.
4) Inactive arm - typically held at the baby's side (Erb's palsy), the nerves going to the arm can be stunned from stretching during the delivery process.
Skin Discoloration
Newborns can be born with birth marks of many different kinds. More common ones include:
1) Moles - pigmented spots of various sizes, shapes and coloration anywhere on the body. These typically last.
2) Redness on forehead, eyelids, nose, lip, and nape of neck is usually a Capillary Nevus. These disappear over months.
3) Large Pigmented discoloration - usually over the buttocks and or back (Mongolian spot) more commonly found in African American newborns. Usually resolve over months to years.
4) White spots over the nose is called Milia and disappears within days to weeks.
Tags, Dimples, and Pits
Though skin tags can be found anywhere, beside an ear is the most common place. The only concern is esthetic and can be removed at a a later date.
Skin pits are usually beside an ear (and have no significance) or over the lower spine on the back. Solitary coccygeal pits are the most common cutaneous anomaly detected on neonatal spinal exam. They are located BELOW the level of a symmetric intergluteal crease directly above the tip of the coccyx and are benign variants that do not require any further evaluation with imaging..Guevara 11/11/21 Hopkinsallchildren.org:
Sacral dimples are indentation (dimple or pit) overlying the sacrum located ABOVE a normal rectal crease (picture). If large or appears near a tuft of hair, skin tag, or discolored area, sacral dimples can be associated with a spine problem. A spine Ultrasound is done initially to investigate.
Hydroneprosis
Sometimes an Ultrasound (US) obtained by your OB finds a dilatation of your baby's kidney while inside the womb (in utero), called pelviectasis. In this case, the funnel of the collecting system is dilated. Your baby may receive a renal US after birth to confirm these findings, to grade its significance, and to serve as a baseline for comparison.
Additional outpatient ultrasounds and follow up with a Pediatric Urologist may be needed. If so, a referral will be made, and a copy of your baby's US will be sent to the specialist. For a better understanding of this condition discuss with your Pediatrician/Urologist and review the information from the following link: http://paedsportal.com/referrals/pre-referral/renal-dilation