A1,420-g male infant was delivered by cesarean section. His 22-year-old mother first went to her local hospital with premature onset of labor and a footling breech presentation. The mother was then transported to the hospital of delivery. She had received no prenatal care and had a history of myalgia, headaches, and fatigue one week prior to parturition. The Apgar score was 5 at both one and five minutes. The infant's muscle tone, respiratory rate, and spontaneous activity were decreased at birth. His airway was intubated and 100% oxygen was administered in the delivery room.
Physical examination on admission to the intensive care nursery disclosed an afebrile, small-for-gestational-age infant with multiple 1-mm petechiae over the torso and extremities. The head circumference was 25.5 cm, and the soft and flat anterior fontanel measured 2 × 2.5 cm. Normal breath sounds were heard over the lung fields. A grade 3/6 harsh
Hoekelman RA, Anderson VM. Congenital Thrombocytopenia, Hepatosplenomegaly, and Growth Retardation: A Clinicopathologic Conference. Am J Dis Child. 1982;136(3):258–264. doi:10.1001/archpedi.1982.03970390072019
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