Case 3: Late Preterm Infant with Multiple Seizures

Abstract

A newborn male infant is delivered by a gravida 2 woman at 36 weeks of gestation via emergency cesarean section because of decreased fetal movements. The antenatal period was uneventful. The woman had a low-grade fever (100°F [37.8°C]) before delivery, which eventually subsided within 24 hours. The neonate did not require any resuscitation and had normal Apgar scores. He developed tachypnea immediately after birth and remained at the birth center NICU. His breathing normalized in a few hours, and he was moved to be with his mother and started breastfeeding. On the second day, the mother noticed that the infant was lethargic and not feeding well. She also noticed an increased respiratory rate. The infant was moved to our center for further management. At admission, the neonate was 41 hours old; had tachypnea (respiratory rate of 77 breaths per minute); was grunting; and had a heart rate of 161 beats per minute, capillary refill time of 4 seconds, cold peripheries, pallor, and low-volume pulse. His noninvasive blood pressure was 54/30 mm Hg. Oxygen saturation in room air was 85%. Systemic examination revealed normal breath …