A 38 5/7-weeks’-gestation male was born to a 23-year-old G1P0 woman who had received prenatal care and whose pregnancy was uncomplicated. Spontaneous rupture of membranes occurred at home, and the fluid was clear. Her group B streptococcus status was unknown. Because labor was ineffective, oxytocin was administered. The second stage of labor was slightly longer than 2 hours. The treating nurses noted variable and late decelerations, tachysystole, and intermittent sinusoidal fetal patterns on the fetal heart rate tracings. The anesthesiologist placed an epidural, and vaginal delivery was allowed to proceed. The infant had meconium staining. The arterial cord blood gas had a pH of 7.13, a Pco2 of 64 mm Hg, a Po2 of 12 mm Hg, and a base deficit of –8. The venous cord blood gas had a pH of 7.31, a Pco2 of 41 mm Hg, a Po2 of...

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