A Fullterm Neonate with Respiratory Distress and Meconium Staining*

This male newborn baby was transferred from a private OBIGY clinic because he had not cried at birth on August 28, 1987. He was the second baby to a 32-year-old mother and was born by vacuum extraction at the gestational age of 38 317 weeks. At birth his skin was stained with meconium and he did not cry. In spite of resuscitation, he had no regular self respiration. He was transferred to SOWHA Children's Hospital one hour after birth. On physical examination, the body weight was 3,250 gm, height 51 cm, head circumference 36 cm and chest circumference 33 cm. Respiration was irregular. The skin was cyanotic and stained with meconium. The anterior fontanel was open and flat. A large caput succedaneum was noticed. The neck was supple. Chest wall retraction was prominent. Respiration was irregular but breathing sounds were unremarkable. The heart murmur was not heard. The abdomen was soft without distension. The liver and the spleen were not palpable. Extremities and external genitalia were unremarkable without cyanosis or deformity. General activity, Moro and sucking reflexes were poor. Laboratory data on admission; CBC revealed Hb 19.3 gm%, Hct 58% and WBC count 34,500