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A female infant born at 40+3 weeks gestation with a birth weight of 3450 grams. The mother was G2P1 with known hypothyroidism, antibody negative. The pregnancy was uncomplicated and there was spontaneous onset of labour. The amniotic fluid was initially clear when membranes were artificially ruptured, but soon after there was loss of blood. Simultaneously, a deceleration was seen on the CTG. A fetal scalp blood sample showed a pH of 6.84 and an emergency caesarean section was performed. There was no heartbeat, no tone and no spontaneous breathing at
birth. After aspiration of blood from her throat, resuscitation was commenced, initially with mask and bag ventilation, followed by intubation after 7 minutes. Chest compressions were started and two doses of adrenalin were given. The first gasp was seen at 15 minutes. Apgar scores were 0, 3 and 5 at 1, 5 and 10 minutes respectively. At the referring hospital 10 ml/kg saline was given and because of hypotension dopamine was commenced (5 microgram/kg/min). Because of the blood loss an erythrocyte transfusion was also given.
The infant was transported to our NICU because of the severe asphyxia and the need for ventilation and hypothermia treatment.
Please download following .PDF to view the full clinical case study.
Dr. Linda van Rooij
Department of Neonatology,
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