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Images in neonatal medicine
The importance of autopsy after failed delivery room resuscitation
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This female infant was born at 34 weeks of gestation by spontaneous vaginal delivery following increasing polyhydramnios and premature rupture of membranes. At 22 weeks of gestation, a left-sided diaphragmatic hernia with minimal mediastinal shift and a favourable head-to-lung ratio had been diagnosed. After delivery, following a short period of bag-mask ventilation with apparently appropriate chest excursions, oro-tracheal intubation was performed without difficulty by a senior neonatologist. When no chest excursions were visible despite high inspiratory pressures, endotracheal tube malposition was assumed and bag-mask ventilation …