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American Academy of Pediatrics
Visual Diagnosis

A Term Newborn Who Has Jittery Movements

Henry Lee and Omar Abdul-Rahman
NeoReviews August 2005, 6 (8) e403-e406; DOI: https://doi.org/10.1542/neo.6-8-e403
Henry Lee
Department of Pediatrics, Division of Neonatology, Stanford University Medical Center, Stanford, Calif.
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Omar Abdul-Rahman
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The Case

A newborn term female presents with jittery movements soon after delivery.

Prenatal History

  • 33-year-old primigravida Caucasian mother

  • Estimated gestational age of 41 weeks

  • Pregnancy was the product of in vitro fertilization

  • Maternal blood type, rapid plasma reagin nonreactive, hepatitis B surface antigen negative, rubella immune, group B Streptococcus (GBS) screen negative

  • Spontaneous rupture of membranes occurred more than 18 hours prior to delivery, and amniotic fluid tinged with light meconium

  • Mother received five doses of ampicillin for prolonged rupture of membranes

Birth History and Presentation

The delivery occurred at a birthing center. The infant was delivered from vertex presentation by spontaneous vaginal delivery. A pediatric team was present at the delivery. The infant was intubated, and a small amount of meconium was suctioned from the airway. She was depressed, with no respiratory effort, and required resuscitation with bag-mask ventilation. Apgar scores were 2 at 1 minute, 3 at 5 minutes, and 4 at 20 minutes. She received one dose of naloxone without appreciable improvement. At 30 minutes after delivery, the infant had spontaneous respirations, and oxygen saturation was 100% with blow-by oxygen. Birth weight was 4,050 g.

A blood gas drawn from an umbilical venous line revealed:

  • pH of 7.12

  • PCO2 of 40.4 mm Hg

  • PO2 of 112 mm Hg

  • HCO3 of 13.6 mEq/L (13.6 mmol/L)

  • Base deficit of 16 mEq/L

A neonatologist was consulted, and the patient was transported to a neonatal intensive care unit. …

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NeoReviews
Vol. 6, Issue 8
1 Aug 2005
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A Term Newborn Who Has Jittery Movements
Henry Lee, Omar Abdul-Rahman
NeoReviews Aug 2005, 6 (8) e403-e406; DOI: 10.1542/neo.6-8-e403

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A Term Newborn Who Has Jittery Movements
Henry Lee, Omar Abdul-Rahman
NeoReviews Aug 2005, 6 (8) e403-e406; DOI: 10.1542/neo.6-8-e403
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  • Severe Intrauterine Growth Restriction, Thrombocytopenia, and Direct Hyperbilirubinemia in a 26-week Premature Infant
  • An Unexpected Brain Lesion in a 2-month-old Infant
  • A Large Tortuous Umbilical Cord with Superficial Abdominal Wall Varicose Veins in a Newborn
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