Variation in Management of Cutaneous Lumbosacral Findings in Newborns
| Autor: | Janelle L. Aby, Jaspreet Loyal, Lillian Lai, Valerie J. Flaherman, Juliann Kim |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Pediatrics medicine.medical_treatment MEDLINE Spinal ultrasound Subspecialty Asymptomatic 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans 030212 general & internal medicine Neural Tube Defects Ultrasonography medicine.diagnostic_test business.industry Infant Newborn Magnetic resonance imaging General Medicine Magnetic Resonance Imaging Pediatrics Perinatology and Child Health Neurosurgery medicine.symptom business Watchful waiting Lumbosacral joint |
| Zdroj: | Hospital pediatrics. 10(6) |
| ISSN: | 2154-1671 |
| Popis: | BACKGROUND: Cutaneous lumbosacral findings in neonates are common in the newborn nursery but may also be associated with occult spinal dysraphism. Variation in management of lumbosacral findings by neonatal clinicians has not been previously described. METHODS: Clinicians in the Better Outcomes through Research for Newborns (BORN) Network were invited to participate in an electronic survey. Participants reviewed 18 photographs of lumbosacral findings in asymptomatic neonates and selected 1 or more initial management step(s): routine care, watchful waiting, imaging, and/or subspecialty consultation. Additional data collected include ease of access to imaging and subspecialty consultants and characteristics of respondents. RESULTS: Of 407 BORN Network clinicians, 206 (51%) completed the survey. Respondents were in >90% agreement in initial management approach of 8 of 18 cases. The most common initial actions were spinal ultrasound (53%), neurosurgery evaluation (18%), and MRI (13%). Anomalies of the gluteal crease had the lowest proportion of agreement. In 2 cases, there were differences in respondents’ choice to image or consult a subspecialist depending on their percent clinical full time equivalent spent taking care of neonates CONCLUSIONS: Variation in initial management of neonatal lumbosacral findings by clinicians in the BORN Network was seen most often for deviations of the gluteal crease, flat vascular macules, and coccygeal hair. |
| Databáze: | OpenAIRE |
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