This is a 24 and 2/7 weeks, 678 gm male, born to a 34-year-old G2, P0 to 3 woman. Prenatal screens were O positive, antibody negative, hepatitis B surface antigen negative, RPR nonreactive, rubella immune, and GBS unknown.  This was an IVF pregnancy, notable for bleeding in the first trimester. The mother presented to the Hospital on the morning of delivery with premature rupture of membranes.  Betamethasone was given approximately 18 hours prior to delivery.  The mother was also started on ampicillin, gentamycin, and magnesium sulfate. Mother's labor progressed despite magnesium and she developed fever and chills.  Maximum temperature was 101.2 degrees.  Because of progressive labor and concerns for chorioamnionitis, the decision was made to deliver the infants. Delivery was by cesarean section.  The infant was intubated in the Delivery Room and Apgars were 5 at one and 8 at five minutes.  Examination was notable for an extreme pre-term infant, intubated.  Weight was 678 gm.  Chest x-ray shows respiratory immaturity and diffuse bilateral opacities within the lungs, left greater than right, with increased lung volumes.