Pearls of Wisdom
•  Cigarette smoking and cocaine are important causes of placental abruption.
•  A normal biophysical profile or BPP is never associated with fetal acidemia.
•  Observation of the newborn infant is the key to the neurological exam. Look at the baby for at least two minutes before touching them.
•  Retinopathy of prematurity is responsible for more blindness among children in the United States than all other causes combined.
•  The most common cyanotic congenital heart lesion in the newborn period is Transposition of the Great vessels. Tetralogy of Fallot is the most common cyanotic lesion presenting outside the newborn period.
•  The senses continue to develop in the NICU, beginning with touch and ending with vision. Neuronal connections will be affected by negative and positive environmental influences.
•  At term, about 40% of amniotic fluid comes from the fetal urinary tract. The remainder comes from the placenta and lung.
•  A neonate requires 4-8 mg/kg/min of glucose for maintenance of blood glucose levels.
•  Minor chromosomal abnormalities are quite common, affecting nearly one in seven infants.
•  Neonatal seizures are a red flag for neurologic dysfunction and injury and require emergent evaluation and treatment.
•  Bilious vomiting that develops suddenly in an otherwise healthy infant should always be considered a potential emergency due to the possibility of midgut volvulus, and an upper GI contrast study must be obtained immediately to rule it out.
•  The clinician should have a high suspicion for Herpes Simplex virus as a causative organism in the ill appearing neonate. A infant with fever in the first 24 hours of life should be considered to have Herpes infection until proven otherwise.

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