Case presentation
We report a case of 33-year-old G3A1D1 married woman. In her last pregnancy, she had a history of blood transfusions in the first trimester, hydramnios, and was absent of fetal movement. Cesarean delivery was due to fetal-pelvic maladjustment. At birth, the female neonate was cyanosed and suffered from delayed screaming. Thus, the resuscitation protocol was initiated and successfully delivered. On the second day of birth, the neonate had suffered from severe dyspnea with a Spo2 of 80%, a heart rate of 180, and a respiratory rate of 76. On clinical examination, the baby had multiple skeletal malformations (rocker bottom foot (Figure 1), very short neck), microcephaly (head perimeter of 32 cm), large ears (Figure 2), upper teeth, micro mouth, cleft palate, hypotonia, absent reflexes, malformation in genital organs, and a hairy back (Figure 3). No cardiac murmurs were reported, but cardiac echography findings were atrial septal defect (ASD), tricuspid valve failure, and high pulmonary tension. The chest X-ray was unremarkable. Depending on the clinical and morphological features observed, we diagnosed the neonate with PSS. Due to the overall bad respiratory condition, the neonate was admitted to the incubator unit with an oxygen mask and prophylactic antibiotics. No signs of recovery were noted, and eventually, the baby died due to cardiopulmonary failure as resuscitation was ineffective.