A term female infant has a right-sided pedunculated tongue mass, cleft palate, and microcephaly (Fig 1).

  • Born to a 26-year-old multiparous woman

  • Pregnancy was complicated by chronic hypertension. Results of prenatal screening and anatomy scan were unremarkable

  • Spontaneous vaginal delivery

  • Estimated gestational age: 39 0/7 weeks

  • Apgar scores: 8 and 9 and 1 and 5 minutes, respectively

The female infant was transferred to the mother-infant unit in the overseas military hospital and seen by the pediatrician who identified a tongue mass and cleft palate. A lactation specialist evaluated the infant and recommended feeding with a Haberman nipple. At 7 hours after birth, the infant had a cyanotic event that was witnessed by her parents when she was awake and appeared to be choking/gagging. She was transferred to the NICU for further evaluation and observation.

  • Heart rate: 127 beats/min

  • Respiratory rate: 46 breaths/min

  • Blood pressure: 61/37 mm Hg (mean...

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