Down's

Sometimes the best moments in your working day, where you learn the most, is at the end of it...well, at least that’s my reason for going back a bit late today although I was post call.

My friend doing newborn screening downstairs kept passing up babies with hypoglycaemia to the neonatal ward ( I changed wards about 2 ½ weeks ago). Being the kind to do so, he went up to check up on the babies he admitted, I was just about to go home when i saw him. Another friend was clerking a new case. While casually looking at the baby, the friend from downstairs suddenly commented – hey, doesnt that look like a Down’s baby? – no way, but hey there are single transverse palmar creases on both hands. We searched around a bit and found a bit more – low set ears, upward slanting of eyebrows, flat nasal bridge, sandal gap deformities bilaterally..

We called the MO who had also seen the baby for hypoglycaemia. Initially sceptic, he finally concurred with our findings. The more we looked, the more signs we saw.. the flat facial profile, incurved fifth finger etc. Fortunately the tone was normal, and no murmurs can be heard, yet. We decided to document our findings but not diagnose the baby yet.

Then we called our ward specialist, who had also seen the case and was ready to go home. Surprise, surprise, her opinion echoed ours and she ordered for chromosomal studies, an echo, and to counsel the parents on the possible diagnosis and prognosis. Unexpectedly, the baby had passed through 4 doctors of different levels, but everyone was more concerned on the hypoglycaemia, which was the most urgent matter anyway, but it was the one who initially admitted the baby who noticed first. It's pretty exciting when you find something your superiors missed, isn't it.

Since all was well, my friend from downstairs continued on his was to find his baby, only to come back since the one we were examining all this while was the baby he was looking for!

Even the best can miss a thing or two sometimes..hehe

*a few days back, the same specialist told us that if we did learn anything from our stay in the neonatal ward, she wants us to at least be able to diagnose a Down's Syndrome baby