PT  - JOURNAL ARTICLE
AU  - Hannah Marshall
AU  - Kyle Petrie
TI  - An abnormal finding in the third trimester
AID  - 10.1136/archdischild-2019-317455
DP  - 2021 Oct 01
TA  - Archives of disease in childhood - Education & practice edition
PG  - 289--291
VI  - 106
IP  - 5
4099  - http://ep.bmj.com/content/106/5/289.short
4100  - http://ep.bmj.com/content/106/5/289.full
SO  - Arch Dis Child Educ Pract Ed2021 Oct 01; 106
AB  - A healthy woman presented with an antepartum haemorrhage at 35/40 during a low-risk pregnancy with normal antenatal bloods and anomaly scan at 20/40 gestation. Following an abnormal ultrasound (USS), the baby was delivered by emergency C-section. A male infant was born in good condition but admitted to the neonatal unit for monitoring. Examination revealed global hypotonia, a weak uncoordinated suck and absent Moro reflex. He had widened sagittal sutures and a large posterior fontanelle. The remainder of the examination was unremarkable. Abnormal bloods are shown in table 1 . View this table:Table 1 Initial newborn blood results He was treated for suspected sepsis due to jaundice and temperature instability. Cranial USS was performed immediately ( figure 1 ). Urgent MRI of the brain further characterised these abnormalities ( figures 2–3 ). Figure 1 Coronal section of cranial ultrasound obtained on day 1 of life. Figure 2 Coronal section from MRI performed on day 1 of life. Figure 3 Sagittal section from MRI performed on day 1 of life. Questions What are the causes for the abnormalities seen in figures 1–3 ? What investigations should be considered?What is the diagnosis?How do we manage this condition?What are the likely outcomes?Questions Answers can be found on page 2