NeoReviews Vol.7 No.4 2006 e208
© 2006 American Academy of Pediatrics
Index of Suspicion in the Nursery
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Case Presentation
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The neonatal intensive care unit (NICU) team was called by a midwife at a birthing center, who wanted to transfer a newborn who was experiencing respiratory distress. The infant was born at term and was appropriate for gestational age, weighing 3,354 g. He was born via normal spontaneous vaginal delivery without complications to a Caucasian G1P0 mother who had negative serologies. History included an absence of premature rupture of the membranes (PROM), meconium, nuchal cord, or maternal fever. Apgar scores were 9 at both 1 and 5 minutes. At 2.5 hours after birth, the baby was noted to be "ashen," had a respiratory rate of 68 breaths/min with slight retractions, and had an oxygen saturation of 85% to 90%, for which blow-by oxygen was administered. At 3.5 hours after birth, the birthing center, unable to maintain oxygen saturation at greater than 82%, called emergency medical services to transfer the neonate to the NICU. The presumptive diagnosis made by emergency medical services was "respiratory distress of unknown origin, potentially unstable." No . . . [Full Text of this Article]
Jamie Leigh Wells, MD
Mary Marron-Corwin, MD
St. Vincents Medical Center, New York, NY
Copyright © 2006 by the American Academy of Pediatrics.