Routine examination in the neonatal period.
OBJECTIVE
To assess the value of the second neonatal examination as a medical surveillance procedure.


METHODS
Prospective survey of routine neonatal examinations and the abnormalities identified during 8 March-30 June 1988.


METHODS
Maternity unit with an annual birth rate of 5700.


METHODS
For first neonatal examination: 1795 babies born in the unit during the 115 day observation period. For second routine examination: 1747 babies (97.3%) discharged from postnatal ward.


METHODS
Missed abnormalities (present but not previously noted); minor abnormalities (superficial infection or trivial or transient abnormalities not requiring intervention); and important abnormalities (unlikely to have been present at first examination but requiring intervention).


RESULTS
An abnormality was detected in 158 (8.8%) infants on first neonatal examination. 1428 (79.6%) babies had a routine second examination, which disclosed 63 previously undetected abnormalities. Of these, seven (11%) would have been present on first examination, 49 (78%) were considered minor, and seven (11%) important--the most consequential being dislocatable hips (four infants). Thus an important finding was detected by only 0.5% of second examinations.


CONCLUSIONS
A second thorough examination in the early neonatal period cannot be justified as a screening procedure. A repeat examination of the hips alone in the first week of life is necessary.
Moss
G D
GD
Paediatric Department, Southmead General Hospital, Bristol.
Cartlidge
P H
PH
Speidel
B D
BD
Chambers
T L
TL
D000013:Congenital Abnormalities / Q000175:diagnosis; D006618:Hip Dislocation, Congenital / Q000175:diagnosis; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D008403:Mass Screening; D010808:Physical Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors