History of Present Illness (HPI)
A one-week-old newborn is examined in the neonatal intensive care unit (NICU) during morning rounds. The patient was born at 26 weeks gestation due to intrauterine growth restriction (IUGR) and oligohydramnios. Pregnancy history was notable for chlamydia for which the mother received treatment during the first trimester and poorly controlled gestational diabetes. At birth, the patient weighed 1300g (5th percentile) and Apgar scores were 5 and 6 at 1 and 5 minutes, respectively. NICU course was complicated by a patent ductus arteriosus and neonatal respiratory distress, requiring IV dexamethasone and intubation with mechanical ventilation. The patient has been on supportive measures including hydrochlorothiazide and fluid restriction for management of his patent ductus arteriosus. The NICU team consults ophthalmology.
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