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American Academy of Pediatrics
Index of Suspicion in the Nursery

Case 3: Hypoxia in a Full-term Neonate

Suzanne Al-Hamad, Nicholas Pietris, Suma B. Hoffman and Alison J. Falck
NeoReviews November 2020, 21 (11) e768-e771; DOI: https://doi.org/10.1542/neo.21-11-e768
Suzanne Al-Hamad
*Division of Neonatology
†Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD
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Nicholas Pietris
†Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD
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Suma B. Hoffman
*Division of Neonatology
†Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD
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Alison J. Falck
*Division of Neonatology
†Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD
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A male infant is born at a community hospital at 37 weeks and 2 days of gestation via cesarean section because of failure to progress after induction of labor for oligohydramnios of unknown etiology. The maternal history is remarkable for 2 prior miscarriages. The pregnancy is complicated by advanced maternal age and low amniotic fluid index of 2.9. The mother had received prenatal care with unremarkable prenatal laboratory findings. The infant’s Apgar scores are 8 and 9, and he requires routine resuscitation. Ten minutes after birth, the infant is noted to be dusky in appearance with respiratory distress. Preductal pulse oximetry is notable for oxygen saturation of 60% to 65% in room air. After initiation of positive pressure ventilation, the oxygen saturation increases to 75% to 85%. The infant is given continuous positive pressure ventilation of 5 mm Hg at 100% fraction of inspired oxygen (Fio2), and his oxygen saturation increases to 90%. He is then transported to the NICU for further assessment, where chest radiography reveals a right-sided pneumothorax that is promptly treated with needle decompression, and he is then given 6 L of oxygen via high-flow nasal cannula (HFNC). The first arterial blood gas measurement approximately 1 hour after birth shows a pH of 7.13, partial pressure of oxygen (Po2) of 75 mm Hg (10 kPa), partial pressure of carbon dioxide (Pco2) of 55 mm Hg (7.3 kPa), bicarbonate of 24 …

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NeoReviews
Vol. 21, Issue 11
1 Nov 2020
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Case 3: Hypoxia in a Full-term Neonate
Suzanne Al-Hamad, Nicholas Pietris, Suma B. Hoffman, Alison J. Falck
NeoReviews Nov 2020, 21 (11) e768-e771; DOI: 10.1542/neo.21-11-e768

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Case 3: Hypoxia in a Full-term Neonate
Suzanne Al-Hamad, Nicholas Pietris, Suma B. Hoffman, Alison J. Falck
NeoReviews Nov 2020, 21 (11) e768-e771; DOI: 10.1542/neo.21-11-e768
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More in this TOC Section

  • Case 2: Abdominal Distention with Paralytic Ileus in a Neonate
  • Case 1: A Term Neonate with Conjunctival Hemorrhage, Ecchymoses, and Umbilical Hematoma
  • Case 3: Cystic Encephalomalacia and Hyperpigmented Plaques in a Preterm Infant
Show more Index of Suspicion in the Nursery

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