Approach to atypical genitalia Quiz: Ace Your Exams

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A 2-day-old newborn, delivered at 37 weeks' gestation via an uncomplicated spontaneous vaginal delivery, is noted to have atypical genitalia. The mother reports a personal history of a right ovarian mass discovered during pregnancy. Pregnancy was otherwise uncomplicated. Temperature is 37°C (98.6°F), pulse is 135/min, respirations are 33/min, blood pressure is 69/44 mm Hg, and oxygen saturation is 99% on room air. The newborn's length is 49 cm (32nd percentile) and weight is 3,200 g (47th percentile). Physical exam reveals clitoromegaly and a single urogenital opening. Cardiopulmonary and abdominal exams are unremarkable. Laboratory results show normal serum 17-hydroxyprogesterone and electrolyte levels. Chromosomal analysis later reveals a 46,XX karyotype. Which of the following findings on history is most strongly associated with this condition?

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Maternal virilization

Family history of short stature in females

Family history of infertility

Prenatal exposure to lithium

History of consanguinity