| Document Date: 2009-11-10 12:35:35
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MedicalCondition Congenital heart defects / Meningomyelocele/Spina bifida / Omphalocele / complete breech / craniorachischisis / Hypospadias / Spina bifida / Suspected chromosomal disorder / Meningomyelocele / serious neurologic dysfunction / umbilical hernia / Congenital diaphragmatic hernia / coma / preterm birth / gastroschisis / Spina bifida occulta / acrania / fever / transient facial nerve palsy / lethargy / Seizure / fetal tachycardia / tricuspid atresia / leukocytosis / pain / stupor / Clinical chorioamnionitis / Cleft Palate / injury / Meningocele / surfactant deficiency / Also called exomphalos / anomalous pulmonary venous return / Fetal Death / peripheral nerve injury / hypotonia / Trisomy 21 / Cyanotic congenital heart disease / Cleft Lip / herniation of meninges / hypoxic-ischemic encephalopathy / neurologic findings / Also called anencephalus / Significant birth injury / chorioamnionitis / Anencephaly / anemia / Syndrome / Disorders / respiratory distress / suspected neonatal sepsis / hypotension / / MedicalTreatment incision / hysterectomy / Antibiotics / acoustic stimulation / amputation / surfactant replacement therapy / mechanical ventilation / / MusicGroup Yes / None of the above / / Person Specify / / Position fetal head / / Product Penicillin / dexamethasone / Gentamicin / Ampicillin / Erythromycin / hydrocortisone / Ceftriaxone / /
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ATTACHMENT TO THE FACILITY WORKSHEET FOR THE LIVE BIRTH CERTIFICATE FOR MULTIPLE BIRTHS