What is Harlequin's Sign?

  1. 0
    I have an OB test on Thursday. What is Harlequin's sign as it relates to the newborn? The net is not helping me.

    Thanks.
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  3. 21 Comments so far...

  4. 0
    Isn't Harlequin's sign those red marks on the babies' forehead? They are supposed to resolve after 1-2 yrs.
  5. 0
    If you use the search engine Monster Crawler and type it in a site which mentions it does come up.

    http://www.russianadoption.org/Neuro...andinfants.htm
  6. 0
    KittyKat,
    When I worked in NBICU we would occasionally see babies with this. It was as though you'd drawn a line down the center of their body and on one side the skin was red and on the other they were white. And I mean a big difference. Don't remember though what the cause is.
    Good luck on the test
  7. 0
    I've been trying to find a picture of it on the internet for you, but I can't seem to track one down. As a NICU nurse, I've seen this happen quite a few times and it's pretty remarkable when you see it. It has to do with the fragility of a newborn's blood vessels during the immediate newborn period.


    Here's a link explaining it, best I could do:

    http://www.drgreene.com/21_494.html
  8. 0
    Thanks for the replies. Sounds dramatic and scary to the uninformed new mom. I will not forget this one.
  9. 0
    Quote from weetziebat
    KittyKat,
    When I worked in NBICU we would occasionally see babies with this. It was as though you'd drawn a line down the center of their body and on one side the skin was red and on the other they were white. And I mean a big difference. Don't remember though what the cause is.
    Good luck on the test
    This concurs with what my Tabers's says, be aware of Harlequin's Sign

    differentiation between

    Harlequin's fetus which is much more severe and the neonate has toad like horny skin with deep red lines and usually fatal within hours of birth
    No cause for either listed in Taber
    Ta DA I learneed something, I have nevr worked OB except my clinicals and here I am learning imagine that.
    Last edit by CCU NRS on Sep 28, '04
  10. 0
    It is a type of vasomotor response...it is pretty astounding to see! It is exactly as someone else said...the baby is divided in half..one half either pale or pink and the other mottled or ruddy.

    Most Harlequin syndromes don't live
  11. 0
    I saw a picture of it once in a medical dictionary and had nightmares afterwards. It looked kinda scary and obviously the baby in the photo was deceased.
  12. 2
    Quote from veteranRN
    I saw a picture of it once in a medical dictionary and had nightmares afterwards. It looked kinda scary and obviously the baby in the photo was deceased.
    Remember, Harlequin's sign is a harmless thing that only happens within the first few hours of a baby's life, a vasomotor response, like BittyBabyGrower said. Here's a photo I found on Google - it's not the best, but you can kind of see the color change. It looks more dramatic in person.

    http://162.129.70.33/images/scan_039.jpg


    Harlequin's Fetus, aka Harlequin Ichthyosis, is a horrible birth defect that is always fatal. There was an article in Neonatal Network last year, I think, that outlined the comfort care provided for these poor souls. It's very frustrating, as it's almost impossible to place or keep an IV secured in these babies, so analgesia is an issue.

    For anyone who is interested, this is a website about that condition. DO NOT click on this unless you are truly intersted in learning more. It's VERY disturbing for most people to see the photos provided.



    http://asylumeclectica.com/malady/ar.../harlequin.htm
    Last edit by Gompers on Sep 28, '04
    SmilingBluEyes and prmenrs like this.


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