A term infant was delivered via elective caesarean section (CS). Antenatal history was unremarkable. Delivery of the head was assisted with the use of Wrigley’s forceps. The baby was born in good condition with Apgar scores of 9, 10 and 10 at 1, 5 and 10 minutes, respectively. She required no resuscitation. Immediately after birth, it was noted that when she cried, there was bilateral supraclavicular swelling. Examination identified neck and upper chest crepitus with positive transillumination. The baby had no respiratory distress and normal saturations. An X-ray was performed at 1 hour of life.

What pathology does the X-ray show? (figure 1)

What are the associated risk factors for the identified pathology? (Select all that apply)

Shoulder dystocia

Macrosomic infant

Traumatic intubation

Non-invasive ventilation

What is the maximum peak inspiratory pressure generated by …