Clinical History.—A 2,100-gm girl was born after a full-term, uneventful pregnancy. There was a spontaneous delivery, but the umbilical cord was around the neck. The baby, however, cried immediately and the Apgar score was 4 at one minute. She was intubated at four minutes, and the Apgar score was 7 at seven minutes.
Physical Examination.—She was an active pink baby. There was only one umbilical artery. The distal parts of both lower limbs were slightly edematous and cyanotic. The temperature was 36.8 C; pulse rate was 120 beats per minute, and respirations, 30/minute. The respiratory and cardiovascular systems were normal, and there were normal neurological reflexes. The abdomen was distended and there was a large, smooth mass in the lower abdomen, extending upwards out of the pelvis. The labia were partly fused in the midline, and there was a small urethral opening below the clitoris. There