North American Registry of Midwives (NARM) Practice Exam

What does unequal bilateral femoral pulses in a neonate typically indicate?

1. Aortic stenosis

2. Coarctation of the aorta

3. Patent ductus arteriosus

4. Mitral valve regurgitation

The correct answer is: Coarctation of the aorta

Unequal bilateral femoral pulses in a neonate typically indicate coarctation of the aorta, which is a condition characterized by a narrowing of the aorta. When coarctation occurs, blood flow to the lower part of the body can be significantly reduced, leading to diminished or absent pulses in the femoral arteries. This is particularly noticeable when palpating the pulses in the legs, as the upper body tends to receive adequate blood flow, while the lower body does not, resulting in the inequality of pulses. In the case of coarctation, the difference in blood flow can lead to a higher blood pressure in the arms compared to the legs, further confirming the diagnosis. Identifying this abnormality is critical since it may lead to complications such as hypertension, heart failure, or even shock in severe cases. Evaluating the femoral pulses is thus an important clinical assessment in the newborn to detect this potentially life-threatening condition. Other conditions listed, such as aortic stenosis and patent ductus arteriosus, do not typically result in unequal femoral pulses. Aortic stenosis often presents with weak or absent pulses along the left side rather than a significant disparity between right and left. Similarly, patent ductus arter