Abstract
A 19-year-old mother presents in established labour to a labour ward in a large teaching hospital following a concealed pregnancy. It is her first pregnancy. At delivery, the baby gives a cry but is noted to have significantly increased work-of-breathing and remains deeply cyanosed. The midwifery team provide PEEP via a face mask and place a crash-call for medical assistance. At the time of the neonatal crash team's arrival at 4 minutes of life the baby boy is receiving facemask PEEP 5 cm H2O in FiO2 0.45. He has deep subcostal and intercostal recessions with grunting and intermittent apnoea. Pre-ductal saturations are 49%. At a glance he appears of a good birth weight with features typical of a term infant. He is noted to have a scaphoid abdomen.
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