A very preterm (29 2/7 weeks) male infant with a birthweight of 998 g is delivered by lower segment cesarean delivery (for transverse presentation with spontaneous leaking). The mother is a 25-year-old gravida 2 woman with no history of consanguinity. There is a history of intrauterine death in a previous pregnancy (at 6 months of gestation) 2 years prior. The neonate does not cry after birth. The Apgar scores are 2 and 5 at 1 and 5 minutes, respectively. The neonate undergoes intubation and is transferred to the nursery for further management in view of ongoing poor respiratory efforts.

Clinical evaluation suggests multiple bruises over the left forearm, left leg, and right leg at birth. Early rescue (bovine) surfactant is administered 45 minutes after birth, ventilator settings are gradually lowered, and the neonate undergoes extubation and receives nasal continuous positive airway pressure (CPAP) 24 hours after birth. The neonate is...

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