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A female infant born at 38+4 weeks gestation with a birth weight of 3170 grams. The mother was G1P0. She was admitted for induction at 38+4 weeks gestation because of pregnancy induced hypertension. On rupture of the membranes there was blood loss and on CTG a fetal tachycardia was seen. An emergency caesarean section was performed and during the resuscitation the infant had profound bradycardia with no spontaneous breathing effort. After 5 inflation breaths the heart rate increased and after 10 minutes she was breathing spontaneously but with an irregular breathing pattern. Apgar scores were 2, 5 and 7 at 1, 5 and 10 minutes respectively. She was admitted to the neonatal unit in an outlying hospital where she stabilized quickly. Her first glucose level was 3.6 mmol/L and she had a capillary sample lactate of 11.2 mmol/L. Around 12 hours after birth she had an incident of bradycardia, followed by a drop of oxygen saturation and thereafter clinical seizure like activity involving both arms and legs. A loading dose of phenobarbitone (20 mg/kg) was given. Ten hours later she developed clinical seizures again with movements of her right arm and a drop in oxygen saturation. Another dose of phenobarbitone was given and she was transported to our NICU for further cerebral monitoring and investigation.
Please download following .PDF to view the full clinical case study.
Dr. Linda van Rooij
Department of Neonatology
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