A 24-year-old woman without a family history of congenital anomalies delivered her first baby after a minimally complicated prenatal course. Poor weight gain led to an ultrasound at 33 weeks gestation; this test and others at 13 weeks to determine gestational age and at 20 weeks to evaluate for anatomic abnormalities all had normal results.
Prenatal screenings included a normal alpha feta-protein level. Review of the mother’s medical records suggested compliance with routine prenatal care and vitamins; however, she smoked cigarettes during the pregnancy and occasionally took a pill containing butalbital, acetaminophen, and caffeine for migraine headaches. She did not have gestational diabetes, but late in the pregnancy she developed hypertension, necessitating induction of labor.
She delivered (via cesarean section) a full-term baby girl weighing 6 pounds, 9 ounces. The infant appeared healthy, with Apgar scores of 8 and 9 and a normal physical exam, except for a 2.5-cm appendage overlying the spine (Figures 1 and 2). The 2-day nursery stay was that of a normal neonate, without complications. The pediatric surgeon who was consulted arranged for outpatient follow-up after hospital dismissal.
FIGURE 1
Skin lesion
The small appendage was in the middle of the infant’s lower back.
FIGURE 2
Close-up
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