Palpate the femoral pulses, at the midpoint of the inguinal ligament. Spend enough time to be sure you are feeling the arterial pulsations and not the movement of the abdominal wall with respiration. Weak femoral pulses should raise the suspicion of coarctation of the aorta. In hypoplastic left heart syndrome or preductal coarctation of the aorta, the femoral pulses may be present for the first 24 to 48 hours and disappear as the ductus closes. Repeated examinations of the newborn are important to be sure that the femoral pulses remain strong after ductal closure.
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