Newborn With a Lumbar Spinal Defect

Wallking Thoughts

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  What is the mother’s pregnancy history?

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  What is the patient’s birth history and comorbidities?

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  What is the patient’s current clinical status (vitals, oxygenation, apneic or bradycardic events)?

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  Is this open spina bifida (myelomeningocele) or closed spina bifida?

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  What does the defect look like (size, presence of a membrane, presence of CSF)?

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  What is his neurological exam—is he able to move his legs?

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  What is the patient’s head circumference and how does the fontanelle feel?

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  Is the patient stable for surgery?