he was born at 2:59 pm this afternoon as the gram product of a 31 twin gestation to a 36 y.o. g4 p2-4 mother with . prenatal laboratory studies included bt o+/ab-, rprnr, ri, hbsag-, and gbs unknown. pregnancy was via ivf with di/di twin gestation. motehr presented to hospital on with preterm labor, and was treated with magnesium, beta-methasone, and penicillin. she was transferred here this morning with persistent labor, and then had to have magnesium therapy discontinued secondary to adverse effects. labor progressed, and she was taken for repeat c-section. betamethasone course would have been complete this evening at 10 pm. twin #1 emerged vigorous, requiring only oxygen in the delivery room; apgar scores were . physical exam: wt gm (75%) l 44 (75%) hc 32 (90%) vs: t 98.4 hr 130s rr 50s bp 52/29 (36) o2sat 95%/ra gen: wd premature infant, moderate respiratory distress heent: fontanelles soft flat, ears/nares nl, palate intact skin: warm, pink, wp chest: moderate aeration, coarse, +g/f/r cardiac: rrr, no m abd: soft, nd, 3vc, no mass gu: normal male, testes in inguinal canal bilaterally, anus patent ext: hips/back normal neuro: tone/activity appropriate dstik: 29 imp: newborn 31 aga preterm infant, born to mother with progressive preterm labor. currently with moderate respiratory distress, likely secondary to rds, and hypoglycemia. at risk for infection given prematurity and maternal hx. hemodynamically stable at present, but at risk for hypotension. Procedure: Continuous invasive mechanical ventilation for less than 96 consecutive hours Insertion of endotracheal tube Non-invasive mechanical ventilation Diagnoses: Observation for suspected infectious condition Twin birth, mate liveborn, born in hospital, delivered by cesarean section Respiratory distress syndrome in newborn Primary apnea of newborn Neonatal bradycardia Other preterm infants, 1,750-1,999 grams Neonatal hypoglycemia 31-32 completed weeks of gestation