A 1220-g male neonate (estimated gestational age, 29 weeks) was born via low-forceps vaginal delivery to an 18-year-old woman (gravida 1) hospitalized for lower abdominal pain and vaginal bleeding. The neonate was limp and cyanotic at birth. His initial heart rate of 50 beats per minute increased to greater than 100 beats per minute after endotracheal intubation, mechanical ventilation, and intramuscular administration of 0.16 mg of atropine sulfate. Apgar scores were 1 and 7 at one and five minutes, respectively. Ultrasonograms of the head at 2 days of age were normal.
The neonate's hospital course was marked by hyaline membrane disease and subsequent bronchopulmonary dysplasia. On day 20, he suffered a severe hypoxic episode requiring cardiopulmonary resuscitation. Subsequently, head ultrasonograms (Figs 1 and 2) and computed tomographic (CT) scans (Fig 3) were obtained.
Perinatal asphyxia in the neonate is a well-recognized cause of brain dam
Denouement and Discussion