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Maximus R.

	Born to a 32 year old primagravida
	Fetal distress (bradycardia) during labor
	C-section-meconium noted at membrane rupture
	Apgar scores 1 and 6 ( at 1 and 5 minutes)
	Persistent hypoxia despite FiO2 1.0 (pO2 >700)
	IPPV initiated without significant increase in pO2
	pH 7.30, pCO2 48, pO2 38, HCO3 22
	Diagnosis: persistent fetal circulation

Composition of Meconium

	Sloughed intestinal epithelial cells
	Swallowed amniotic debris (hair, vernix)
	Squamous epithelial cells
	Pancreatic lipases and proteases
	Bile acids and salts
	Sucus entericus
	White blood cells

Maximus R.

	Born to a 32 year old primagravida
	Fetal distress (bradycardia) during labor
	C-section-meconium noted at membrane rupture
	Apgar scores 1 and 6 ( at 1 and 5 minutes)
	Persistent hypoxia despite FiO2 1.0 (pO2 >700)
	IPPV initiated without significant increase in pO2
	pH 7.30, pCO2 48, pO2 38, HCO3 22
	Diagnosis: persistent fetal circulation

Components of the Apgar Score

	____________Score__________________
	Sign  0 1 2
	Heart rate     Absent           <100       >100
	Respiration      Absent      Irregular     Good cry
	Color              Cyanotic     Acrocyanosis     Pink
	Tone      Limp           Minimal         Active
	Reflex     Absent         Minimal       Active

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