FOLLOW-UP OF HIGH RISK PRETERM INFANTS WITH COMPLEX MEDICAL PROBLEMS: AN ILLUSTRATION OF TWO CASES
Miri Harel OT, Ety Gershon PT, Oxana Vizhgorodsky RN, Marina Soloveichick MD.
NICU Follow-up Clinic
Carmel Medical Center, Haifa, Israel
מעקב פגים בסיכון גבוה עם בעיות רפואיות: תאור של שני מקרים
מירי הראל ריפוי העיסוק, אתי גרשון פיזיותרפיה, אוקסנה ויז'גורודסקי אחות מוסמכת,
דר' מרינה סולובייצ'יק, מרפאת התפתחות ומעקב פגים
מרכז רפואי כרמל, חיפה, ישראל
One of the aims of a follow-up of high-risk preterm infants, especially those with complex medical problems, is to concentrate developmental care and medical follow-up in one place, which might minimize the amount of visits to different centers and provides a unique possibility for comprehensive approach and treatment. We will illustrate this with two case reports.
Case one: extremely preterm infant with complex medical problems at discharge such as oxygen dependent lung disease, visual problems with weekly ophthalmologic consultations, feeding problems, poor weight gain, initially consistent poor quality of spontaneous movements according to Prechtl and insecure parenting .
Case two: late preterm infant with congenital CMV infection and periventricular calcifications with monthly ganciclovir dosage adjustment and multiple blood tests, repeated ophthalmologic and hearing examinations. Again, spontaneous general movements were initially consistently abnormal.
In both cases individually adjusted follow-up programs were offered and accepted. They combined both medical tests and examinations and appropriate developmental interventions. The motor performance assessed by means of Prechtl’s GMs improved in both cases. By using some principles of attachment parenting we focused on strategies that supported secure attachment.
The interdisciplinary management of these two cases illustrates the potential benefits of combined developmental and medical follow-up programs in high- risk preterm infants with medical problems at discharge. Our strategy improved the quality of follow-up care and might improve the outcome. An assessment tool designed to evaluate the contentment of the family might be additionally helpful to document the benefit of such a single-center interdisciplinary follow-up model.