A pregnant woman at 38 weeks' gestation has had ruptured membranes for 30 hours. A cesarean delivery is performed due to failure to progress. After birth, the newborn is noted to be pale and tachypneic
Based on maternal history, the cause of the newborn's distress is most likely to be:
a. Hypoglycemia
b. Respiratory distress syndrome
c. Phrenic nerve injury
d. Sepsis
ANS: D
Prolonged rupture of membranes (greater than 24 hours) predisposes a newborn to infection from pathogens ascending from the vagina or cutaneous transmission as the fetus passes through the birth canal. Pallor, tachypnea, hypothermia, and lethargy may be noted at birth.
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