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July Case Study - Prophylactic barbiturate use for presentation of morbidity and mortality following perinatal asphyxia

Patient Profile

  • Name: Baby X

  • Age: Newborn

  • Gestational Age: 39 weeks

  • Birth Weight: 3.2 kg

  • Delivery: Vaginal, with the assistance of forceps

  • APGAR Scores: 3 at 1 minute, 5 at 5 minutes, and 7 at 10 minutes

Clinical Presentation

Baby X was born after a prolonged second stage of labor. The mother, a 28-year-old G2P1, had an uncomplicated pregnancy until delivery. The baby was delivered with the assistance of forceps after a total labor duration of 14 hours. Upon birth, Baby X had a weak cry, poor muscle tone, and cyanosis.

Initial Management

  • Immediate Actions:

  • Cut the umbilical cord

  • Place the baby on the radiant warmer and thoroughly dry and stimulate the baby from head to toe (must take less than 30 seconds)

  • Airway was cleared due to visible mucus and positive pressure ventilation was initiated.

  • Oxygen was administered.

  • Subsequent Actions:

  • The baby was transferred to the neonatal intensive care unit (NICU).

  • Blood gases showed metabolic acidosis.

  • The baby was placed on a mechanical ventilator.

  • Therapeutic hypothermia was initiated to reduce the risk of hypoxic-ischemic encephalopathy (HIE).

Diagnostic Findings

  • Blood Gas Analysis:

  • pH: 7.1

  • PaO2: 50 mmHg

  • PaCO2: 55 mmHg

  • HCO3: 15 mmol/L

  • Base Excess: -12 mmol/L

  • Imaging:

  • Brain ultrasound: Signs of cerebral edema.

  • Laboratory Tests:

  • Elevated serum lactate levels.

Multiple Choice Questions

What is the most likely cause of Baby X’s condition?

  • A - Congenital heart defect

  • B - Birth asphyxia

  • C - Neonatal sepsis

  • D - Inborn error of metabolism

Which of the following is a primary goal in managing this baby?

  • A - Administering antibiotics

  • B - Providing immediate respiratory support

  • C - Performing immediate surgery

  • D - Ensuring adequate feeding

What is the purpose of therapeutic hypothermia in the management of birth asphyxia?

  • A - To prevent hypoglycemia

  • B - To reduce the metabolic rate and prevent brain injury

  • C - To treat neonatal jaundice

  • D - To improve cardiac function

Which of the following is NOT a typical feature of birth asphyxia?

  • A - Poor muscle tone

  • B - Weak cry at birth

  • C - Cyanosis

  • D - Hyperglycemia

259 views3 comments


a day ago

thank you for this survey question it help me to study


2 days ago

Very interesting and educative case study


Jun 25

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