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Severe subcutaneous emphysema in a term neonate
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The baby was born by elective caesarean section because of breech presentation, at 38+6 weeks of gestation with an Apgar score of 9 at 1 min, 9 at 5 min and a birth weight of 4.02 kg. She was noted to be grunting at 20 min of age and had O2 saturations of 55% in air and therefore commenced on O2 by face mask initially, followed by continuous positive airway pressure (CPAP) at a pressure of 5 cm as O2 requirements remained high (up to 60%). CPAP pressure did not need to be increased further as the O2 requirement came down to 40% and remained between 30% and 40% for the subsequent 24 hours. Initial …