External Examination

The autopsy is performed 9/24/2011. The body is identified by ankle bracelet on both feet as the baby boy of Heather Jean Forsyth. The consent, signed by both parents, is for a complete autopsy.

The body is that of a dysmorphic male infant weighing 1830 grams. The head circumference is 29.2 cm, the chest circumference is 25.7 cm, the abdominal circumference is 24.5 cm, the crown-rump length is 30 cm, the crown heel length is 45 cm, and the foot length is 7.4 cm. These weights and measures are consistent with a 35 wk gestation infant.

The head is covered by black, slightly curly hair measuring 2.1 cm in length. The head is symmetric. The fontanelles are slightly bulging. The anterior fontanel measures 2.3 x 1.2 cm and the posterior fontanel measures 2.1 x 1.0 cm. The sutures are mobile. the face is dysmorphic with prominent forehead sloping. The lips are dry red-brown. The eyes are prominent with an intercanthal distance ratio of 1.9 to 8.1 cm. There is a flat nasal bridge. The nares are patient. The chin is recessed. The scleras are clear. The corneas are clear. The irises are blue. The nose is bilateral patent nares. The mouth is of usual shape. The oral mucosa has pink mucous membranes. The tongue is normally papillated. The soft and hard palate are intact. The frenulum is intact. The ears are low set. The philtrim measures 1.2 cm. The chin is not recessed. The superior attachment of the right ear is 0.2 cm below the lateral canthus and the left ear is 0.8 cam below the lateral canthus. The ears do not have cauliflower or other abnormal appearance. The ear canals are patent. The neck lacks palpable masses.

The chest is asymmetrical with the left chest elevated. The nipples are laterally displaced. The umbilical cord is dry, yellow, and present with clamp and measures 6.8 cm in length and on cut section, 2 vessels are grossly identified. The abdomen is flat and soft. There are red linear superficial partial epidermal thickness skins tears bilaterally in the left lower quadrant and the lateral upper quadrant up to 2 cm in length. The external genitalia are male with descended testes. The anus is patent. The back has prominent Mongolian spot with sacral dimple.

The upper and lower extremities have a restricted range of motion. The radii are absent bilaterally. The left hand is deviated medially and the right hand is deviated laterally. Both right and left hands have four digits: one thumb and 3 phalanges. The right hand has one horizontal crease line. The left hand has no crease lines. There is incomplete fingernail development on both hands bilaterally. The right and left feet are clubbed and both have 5 toes.

The skin is tan white and not sloughed.