IPLab:Lab 13:Hyaline Membrane Disease

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Clinical Summary

This 28-hour-old white male was the product of an uncomplicated vaginal delivery by a G1 24-year-old mother whose pregnancy had also been uncomplicated. The infant was born pre-termBirths occurring at 38 to 42 weeks of gestation are considered term pregnancies. Anytime earlier are considered pre-term. at 36 weeks gestation and was appropriate for gestational ageAppropriate for gestational age (AGA) is a term which means that an infant's weight and height were appropriate when adjusted for the gestational age of the child. Large for gestational age (LGA) and small for gestational age (SGA) are the alternative designations., weighing 2550 gramsThe normal weight for a child of this gestational age would be 2250 to 3000 grams.. Three hours after birth, the infant developed cyanosisCyanosis is a bluish discoloration of the skin and mucous membranes resulting from increased concentrations of reduced hemoglobin in the blood. Cyanosis occurs when the blood oxygen saturation falls below 85%. and required 40% oxygen to maintain a pink color. Because of a worsening respiratory distress syndromeRespiratory distress syndrome (or hyaline membrane disease) is a common complication of prematurity, though it can also be seen in term births. The syndrome results from the functional immaturity of the neonatal lung. The syndrome usually presents within one hour of birth and is initially exhibited clinically by rapid respirations, grunting, and substernal retractions., the infant (1 day old) was transferred to a tertiary care hospital with a neonatal intensive care unit. Following the transfer, the respiratory distress progressed and the admitting arterial blood gases were pH 7.31A normal pH for a child this age would be 7.37., PaCO2 35A normal PaCO2 level for a child this age would be 33., and PaO2 35A normal PaO2 level for a child this age would be 90.. The condition of the patient continued to deteriorate despite therapy, and he became "shocky" with efforts to increase blood volume. He developed a persistent bradycardiaBradycardia is defined as a heart rate below 60 beats per minute. A normal heart rate for a neonate is 100 to 160 beats per minute. and died about 4 hours after admission.

Autopsy Findings

The organs generally showed no abnormalities other than those of immaturity expected at this gestational age. There was moderate diffuse subarachnoid hemorrhage and a small amount of blood in the pleural and pericardial cavities.


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