A Preterm Infant with Hypovolemic Shock: Should Infants be Examined Twice or is Once Enough?

Shock in newborns and preterm infants carries significant morbidity and mortality risks unless there is early recognition and adequate treatment. Signs may only be identified in the late decompensated phase with lactic acidosis, cellular disruption, and irreversible multiorgan damage. In neonates, the etiopathological origin is unique, particularly in extremely preterm infants with a complicated postnatal transition phase, an immature myocardium, and high peripheral systemic resistance. Hypovolemic shock shortly after birth is uncommon and may complicate fetomaternal or fetoplacental transfusion, abruptio placenta, intracranial hemorrhage, or capillary leak syndrome. Without a blood loss history, secondary clinical assessment may reveal the underlying etiology and facilitate targeted interventions