You are called to assess a 12 hours old baby girl in the labour and delivery ward.  The infant has been born at 41 weeks gestation.  The mother is a 39 year old G2P1 woman whose immunizations are unknown and prenatal serologies are protective. Group B streptococcus swabs were positive. The mother did not smoke, drank small amounts of alcohol throughout the pregnancy, and took only maternal vitamins. The mother had gestational diabetes. The labour was 2 hours in duration with membranes ruptured for 8 hours. Meconium was present. The baby was born vaginally with vacuum and forceps   

Since delivery, the nurses have noted the infant appeared to have bruising on the face and arms.

On examination the infant has no dysmorphic features and is alert. The weight, length, and head circumference are all at the 25th percentile. The body has bruising on the torso and a scalp hematoma.  There is normal colour with normal capillary refill with normal S1 and S2 with no murmur.  Chest exam shows  good air entry with no adventitious sounds and easy breathing.   Abdominal exam is normal. Tone is normal and there is spontaneous movements of all four limbs.   Red reflexes of the eyes are normal.


Given this presentation, what is your most likely diagnosis for this neonate?

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Dr. Marc Zucker


Dr. Hosanna Au

Dr. Nicole Johnson



Dr. Theresa Wu