Essential Neonatal Medicine

Sixth Edition

Sunil Sinha, Lawrence Miall and Luke Jardine

Multiple Choice Questions

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Chapter 10, Question 1.

10.1 A 35-week preterm female infant is now 4 hours old and self-ventilating in air. She was born via emergency LSCS for breech position after preterm labour. Her mother was given 1.2 g IV benzylpenicillin 3 hours before delivery. Apgars were 91 and 95 respectively, birth weight was 2600 g. In the last hour the baby has had four episodes where she stopped breathing for >20 seconds, her heart rate dropping to <80 beats per minute and her oxygen saturations to <70%. She requires firm stimulation by the nursing staff to resolve these episodes. Between episodes her oxygen saturations on pulse oximetry are 96% and her examination is normal. She is not currently on any medications. Which one of the following options is the most appropriate next step in the management of her apnoea?

A Place her in 30% oxygen.

B Commence caffeine for apnoea of prematurity.

C Perform a sepsis work-up and commence IV antibiotics.

D Start mask continuous positive airway pressure (CPAP).

E Intubate and ventilate the baby.