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July 1991

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1991;117(7):804-808. doi:10.1001/archotol.1991.01870190116026

PATHOLOGIC QUIZ CASE 1  Robert J. Weil, MD, Chicago, IllA 3000-g full-term female infant was born by vacuum extraction to a 28-year-old gravida 2, para 1 woman, whose pregnancy had been uncomplicated. The infant became markedly depressed when the umbilical cord was clamped; the Apgar scores were 0, 0, and 4 at 1, 5, and 10 minutes, respectively. Oxygen was administered by mask. Initial attempts at endotracheal intubation were unsuccessful; the infant was intubated after 1 hour. Bilateral pneumothoraces required chest tubes. On physical examination, coarse breath sounds were heard bilaterally, the abdomen was distended, and the skin was cyanotic. The findings of the cardiovascular examination were normal, and no external dysmorphic features were noted. Later attempts to place a larger endotracheal tube did not improve ventilation (Fig 1). Nearly 16 hours after birth, the infant died. There were no notable findings at postmortem examination, except those shown

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