A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours.A cesarean section is performed for failure to progress.The fetal heart rate (FHR)before birth is 180 beats/min with limited variability.At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic.On the basis of the maternal history,the cause of this newborn's distress is most likely to be:

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The prolonged rupture of membranes and the tachypnea (before and after birth)both suggest sepsis.An FHR of 180 beats/min is also indicative.This infant is at high risk for sepsis.

A Pregnant Woman at 37 Weeks of Gestation Has Had