The newborn examination: Part II. Emergencies and common abnormalities involving the abdomen, pelvis, extremities, genitalia, and spine

Careful examination of the neonate at delivery can detect anomalies, birth injuries, and disorders that may compromise successful adaptation to extrauterine life. A newborn with one anatomic malformation should be evaluated for associated anomalies. If a newborn is found to have an abdominal wall defect, management includes the application of a warm, moist, and sterile dressing over the defect, decompression of the gastrointestinal tract, aggressive fluid resuscitation, antibiotic therapy, and prompt surgical consultation. Hydroceles are managed conservatively, but inguinal hernias require surgical repair. A newborn with developmental hip dysplasia should be evaluated by an orthopedist, and treatment may require use of a Pavlik harness. The presence of ambiguous genitalia is a medical emergency, and pituitary and adrenal integrity must be established. Early diagnosis of spinal lesions is imperative because surgical correction can prevent irreversible neurologic damage.