Case history
Case history #1
A 19-year-old woman presents to the emergency department in active labour. She states she is 27 weeks pregnant and that her waters broke a few days ago. She is rushed to obstetrics for an immediate examination. Fetal monitoring reveals severe prolonged heart rate decelerations and an emergent caesarean section is performed for fetal indications. The infant is born apnoeic, floppy, and bradycardic. There is no vernix present and there is sparse lanugo.
Case history #2
A 22-year-old multiparous woman who has continued to smoke 10 cigarettes per day during pregnancy presents to her obstetrician in premature labour and with premature rupture of membranes. The fetus is currently at 34 weeks' gestation. On examination she is dilated to 7 cm, has contractions every 3 minutes, and the obstetrician confirms that delivery is imminent. The infant is delivered vaginally and appears well immediately after birth. Apgar scores are 9 at both 1 and 5 minutes of age.
Other presentations
While an extremely premature infant is more likely to require extensive and immediate resuscitation after birth, some premature infants require only limited support (e.g., temperature and glucose homeostasis). Conversely, some term and post-term infants may have significant instability requiring urgent and timely intervention immediately after birth. Each newborn must be evaluated on an individual basis.
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