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Chorioamnionitis is usually due to group B streptococcal or Escherichia coli
infections. Ampicillin and gentamycin are reasonable empiric antibiotics in a
newly born infant with suspected chorioamnionitis (see Chapters 73 SepticAppearing Infant and 94 Infectious Disease Emergencies ).

POSTRESUSCITATION CARE
Once effective ventilation and circulation are established, the infant should be
continuously monitored and safely transported to a neonatal unit or a facility with
a neonatal unit. These infants are at tremendous risk for deterioration even after
their vital signs have returned to normal. The patient should be transported by
personnel with appropriate expertise along with appropriate equipment and
medications.

SPECIAL SITUATIONS
Withholding Resuscitation
There is no validated prognostic score to guide determination of initiation of
resuscitation in infants born at less than 25 weeks’ gestational age. Decisions
about appropriateness of resuscitation below 25 weeks’ gestational age should be
influenced by region-specific guidelines. These decisions should be
individualized, based on available resources, and inclusive of mother and family.

Discontinuing Resuscitative Efforts
An Apgar score of 0 at 10 minutes is a strong predictor of mortality and
morbidity in late preterm and term infants. Therefore, if the HR remains
undetectable following 10 minutes of resuscitation, it likely is futile to continue
assisted ventilation. These decisions should be individualized, based on available
resources, and inclusive of mother and family.

Induced Therapeutic Hypothermia
Data from large, multicenter, randomized controlled trials have demonstrated that
systemic or selective head cooling hypothermia initiated within 6 hours of life, in
infants ≥36 weeks reduced death or neurologic disability in infants with moderate

or severe hypoxic-ischemic encephalopathy. The American Academy of
Pediatrics (AAP) Committee on Fetus and Newborn and the AHA guidelines
recommend that infants ≥36 weeks’ gestation who have moderate to severe
hypoxic encephalopathy be offered therapeutic hypothermia. Currently,
hypothermia therapy is not recommended for infants less than 36 weeks’
gestation as clinical trials are needed for this age group.