The newborn diagnosed with phenylketonuria (PKU) will require long-term follow-up to assess for the development of:

Choice A:

Two arteries and two veins. This is incorrect because the umbilical cord normally has only three blood vessels: one vein and two arteries. Having four blood vessels is a rare anomaly that can be associated with congenital defects. •

Choice B:

Two veins and one artery. This is incorrect because the umbilical cord normally has only one vein and two arteries. Having two veins and one artery is another rare anomaly that can also be associated with congenital defects. •

Choice C:

One artery and one vein. This is incorrect because the umbilical cord normally has two arteries and one vein. Having only one artery and one vein is a common anomaly that occurs in about 1% of singleton pregnancies and 5% of twin pregnancies. It can be associated with intrauterine growth restriction, congenital anomalies, and perinatal mortality. •

Choice D:

Two arteries and one vein. This is correct because the umbilical cord normally has two arteries and one vein. The vein carries oxygenated blood from the placenta to the fetus, while the arteries carry deoxygenated blood from the fetus to the placenta. The umbilical cord also contains Wharton's jelly, which is a gelatinous substance that protects the blood vessels from compression.

Choice A reason:

Scant scalp hair is not an expected finding for a newborn who is post-term. Scant scalp hair is more common in preterm infants who have not developed fully.

Choice B reason:

Copious vernix is not an expected finding for a newborn who is post-term. Vernix is a white, cheesy substance that covers the skin of the fetus and protects it from the amniotic fluid. Vernix is usually abundant in preterm infants and decreases as gestation progresses.

Choice C reason:

Increased subcutaneous fat is not an expected finding for a newborn who is post-term. Increased subcutaneous fat is a sign of adequate nutrition and growth, which is more likely in term infants. Post-term infants may have reduced subcutaneous fat due to placental insufficiency and decreased nutrient supply.

Choice D reason:

Dry, cracked skin is an expected finding for a newborn who is post-term. Dry, cracked skin is a result of prolonged exposure to the amniotic fluid, which causes dehydration and desquamation of the skin. Post-term infants may also have meconium staining on their skin due to fetal distress.