Reference no: EM133277662

Giselle was delivered 2 months early via caesarian section at 32 weeks gestation to a nulliparous woman. Doctors recommended this course of action due to apparent intrauterine growth restriction. It was noted on a routine ultrasound that Giselle had a missing artery in her umbilical cord, so doctors attributed her slow growth to this anomaly. Upon delivery it was noted that her head circumference was small for her size, she had low set ears, and a larger than average distance between her eyes.

At 6 months old corrected, Giselle was brought to the hospital for continued failure to thrive. Her parents reported that she initially appeared to be a typical baby. Now that she's a bit older, however, they notice she seems not to be meeting appropriate motor-milestones. She can't quite bring her hands to mouth and mostly leaves her arms outstretched at her side. At 6 months, she still struggles to sit up. She is not able to lift her head when placed on her tummy. She seems very loose or floppy with her muscle movements. She is bottle fed and she has had some gagging and choking when the bottle is offered to her. Doctors attributed this to her cleft lip and palate, which was repaired shortly after birth. She does not cry much and seems content, but her therapist at clinic notes that she doesn't yet show interest in her hands, explore toys with her mouth, reach for toys within her grasp, or seem to recognize her parents or orient toward their voices.

Question 1. Write down (you may list) information from above that you believe will be relevant in helping you uncover Giselle's diagnosis (at least 5 things).

1. Giselle having been born via caesarian at 32 weeks old, too early.

2. Umbilical cord's missing artery.

3. Small head size/circumference in comparison to her overall size.

4. Low set ears.

5. Greater than average distance between her eyes.

6. Cleft lip and palate at birth.

7. Missing motor skill milestones: lifting head, limp movements, gagging/choking.

8. No recognition of parents.

Question 2. Using the information you selected as relevant , begin to conduct research. What are some possible diagnoses you should consider exploring? Please write down and describe in detail approximately 5 potential diagnoses that you might explore.