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NeoReviews Vol.10 No.4 2009 e198
© 2009 American Academy of Pediatrics

Index of Suspicion in the Nursery

The first 20% of the full text of this article appears below.


   Case Presentation
 
An 18-year-old gravida 1 woman delivers a 600-g male infant at 28 weeks estimated gestational age by emergency cesarean section. The pregnancy was complicated by oligohydramnios, pregnancy-induced hypertension, and intrauterine growth restriction. Labor was induced due to worsening hypertension, and an emergency cesarean section was performed due to abruption. The baby's Apgar scores are 3 at 1 minute and 7 at 5 minutes.

The infant is resuscitated initially with infant ventilation in the delivery room. However, the development of marked respiratory distress, deep retractions, and poor air entry bilaterally prompts endotracheal intubation and placement of the infant on mechanical ventilation. Ventilator settings are: positive inspiratory pressure of 17 mm Hg, positive end-expiratory pressure of 5 mm Hg, FiO2 of 0.4, and intermittent mandatory ventilation of 35 breaths/min. Surfactant is administered because of continued respiratory distress, and dopamine administration is initiated for persistent low blood pressure. Serum is obtained for hematology laboratory evaluation and blood culture, abdominal and chest radiographs are taken to evaluate respiratory status, and empiric antibiotic therapy with intravenous . . . [Full Text of this Article]

Venkatakrishna Kakkilaya, MD
Guillermo Sangster, MD
Dalibor Kurepa, MD
Sameh Hussein, MD
Hassan Ibrahim, MD

Louisiana State University Health Science Center, Shreveport, La


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