A male infant weighing 2700 g was born by cesarean section at 35 weeks' gestation to a 31-year-old gravida 6 para 5 mother who had an uncomplicated pregnancy.
At birth the infant was cyanotic and dysmorphic. An initial chest roentgenogram (Fig 1) and an echocardiogram were obtained. Echocardiography showed a dilated right atrium and biventricular enlargement with a large right-to-left ductal shunt.
Despite intense medical therapy, the infant's level of oxygenation deteriorated. In anticipation of beginning extracorporeal membrane oxygenation therapy, cranial ultrasonography was performed (Fig 2). Following ultrasonography a skull series was obtained (Fig 3).
Despite aggressive treatment the patient's condition worsened. Attempts at cardiopulmonary resuscitation provided only temporary improvement and he died within several hours.
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