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Routine examination in the neonatal period
G D Moss1, P H Cartlidge, B D Speidel
1Paediatric Department, Southmead General Hospital, Bristol.
BMJ (Clinical Research Ed.)
|April 13, 1991
Summary
A second neonatal examination is not a valuable screening tool for detecting abnormalities. A focused hip examination in the first week of life is recommended for early detection of developmental dysplasia.
Area of Science:
- Neonatal Medicine
- Pediatric Surveillance
- Medical Diagnostics
Background:
- The routine second neonatal examination is a standard practice in many maternity units.
- Its effectiveness as a medical surveillance procedure for identifying abnormalities has been questioned.
Purpose of the Study:
- To evaluate the diagnostic yield and medical value of the second neonatal examination.
- To determine if a comprehensive second examination is a justifiable screening procedure.
Main Methods:
- A prospective survey was conducted on routine neonatal examinations over a 115-day period.
- Abnormalities were categorized as missed, minor, or important, with a focus on those detected during the second examination.
Main Results:
- The first neonatal examination identified abnormalities in 8.8% of infants.
- The second examination, performed on 79.6% of babies, revealed 63 previously undetected abnormalities.
- Only 0.5% of second examinations identified important abnormalities, such as dislocatable hips.
Conclusions:
- A comprehensive second neonatal examination is not supported as an effective screening procedure.
- A targeted repeat examination for hip abnormalities within the first week of life is considered necessary.