An infant who weighs 3.8 kg is delivered vaginally at 39-weeks gestation with a nuchal cord after a 30-minute second stage. The nurse identifies petechiae over the face and upper back of the newborn. What information should the nurse provide the parents about this finding?

• A. Further assessment is indicated
• B. Petechiae occurs with forceps delivery
• C. An increased blood volume causes broken blood vessels
• D. The pinpoint spots are benign and disappear within 48 hours

Answer: (D)

Birth-related petechiae in a healthy term newborn are usually from tiny capillary breaks that occur during labor as the baby moves through the birth canal. The spots on the face and upper back fit this common birth-trauma pattern and, in the absence of other symptoms, are typically harmless. They should resolve on their own without treatment within about 48 hours to 2 days.

Reassure the parents that no special care is needed for the spots, but advise them to monitor the newborn. If the petechiae persist beyond 48 hours, or if the baby develops fever, poor feeding, lethargy, or new bruising or bleeding elsewhere, they should contact a pediatrician promptly.