A male infant with a myelomeningocele (diagnosed by prenatal ultrasound) was delivered vaginally. He was floppy and apneic at delivery and required one minute of positive pressure ventilation. Apgars were 4 and 7 at 1 and 5 minutes respectively. The fontanels were bulging but soft, there was a sacral tuft of hair and there were neurological deficits below the myelomeningocele.
Chiari malformation with moderate hydrocephalus was also documented on prenatal ultrasound. Examination was negative for other anomalies including cardiovascular and genitourinary.
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