Case 322

Case 322

Medical history

Newborn with apnea at birth after emergency cesarean section, received two cycles of positive pressure ventilation (PPV) with bag and mask ventilation and application of continuous positive airway pressure (CPAP) in the delivery room. Admitted to the neonatal ICU and submitted to orotracheal intubation. Chest and abdomen x-ray were requested (picture 1). Primipara subjected to induction of labor at 40 weeks due to gestational diabetes controlled with diet. It evolved with amniorrexe of meconial liquid and report of fetal tachycardia after 7 hours of amniorrhexis.

Image 1: Chest and abdomen radiograph, anteroposterior view, supine.

Considering the most likely diagnosis, what treatment should be done in all patients with this disorder?

Test question

(Federal University of Uberlândia – 2016) Preterm new born, 36 weeks of gestational age, was born of cesarean delivery, due to fetal bradycardia, with rupture of membranes during the labor and outlet of fluid meconial amniotic fluid. The newborn in poor conditions with need of resuscitation in the delivery room, including orotracheal intubation. Referred to the Neonatal ICU and maintained in invasive ventilatory support. Chest radiograph with diffuse coarse infiltrate. The diagnosis for this case is: