A set of 32-weeks' gestation, concordant, diamniotic-dichorionic twins was delivered via cesarean section to a mother whose pregnancy was uncomplicated until preterm labor began. Tocolysis was attempted but failed. One dose of betamethasone was given. Twin A was a male whose birthweight was 1,796 g and whose Apgar scores were 7 at 1 minute and 8 at 5 minutes. The baby had respiratory distress syndrome for which he received one dose of surfactant and assisted ventilation at low settings. He had mild anemia at birth (hematocrit of 38% [0.38]), hyperbilirubinemia requiring a brief period of phototherapy, and a patent ductus arteriosus treated successfully with one course of indomethacin. He received ampicillin and gentamicin for 3 days until infection was ruled out.

On postnatal day 3, cranial ultrasonography showed a questionable germinal matrix hemorrhage, but repeat scans appeared totally normal. On postnatal day 5, the baby was extubated to nasal continuous...

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