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DAY 4 of life ,late preterm, birth wt 2 kg,(prob monozygotic )twins ,delivered by LSCS ,monochorionic diamniotic twins ,normal transition at birth ,both has clinical features suggestive of downs syndrome,karyotyping sent (takes 3 weeks for the report in our setup),1 st twin is doing fine,( counts are normal for both twins ,except for high retic count ,mother rh negative ,second order of birth ,previous anti d given ),second one developed severe pulmonary hypertension due to high hemotocrit,was on ventilator ,partial exchange done for worsening saturation (twice) ,dramatic improvement in saturation ,now on oral sildanefil.is there anything i should do further regarding genetic workup.

dr ramesh kumar

neonatologist ,nagercoil,tamil nadu,chennai,india

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