Case 166

Case 166


A full-term male infant was born by vaginal delivery. Shortly after birth, the baby presented apnoea and less than 100 bpm heart rate, and then resuscitation manoeuvres were performed in the delivery room. It received positive pressure ventilation with self-inflating bag and endotracheal tube. Apgar scores were 2 and 9 at first and fifth minute, respectively. The newborn was presented to the parents and referred to the neonatal unit of progressive care (NUPC). Clinical examination revealed decreased breath sounds on the left hemithorax, scaphoid-appearing abdomen and barrel-shaped chest. Also, there was a relate of inadequate prenatal care, with only three visits to the health centre and one ultrasound exam carried out, which was done in the first trimester of pregnancy and did not reveal any abnormality. In the NUPC, chest and abdomen bedside radiography was requested.

Image 1: Anteroposterior (AP) chest and abdomen radiography

Given the clinical presentation and image attached, which would be the most appropriate approach?