scholarly journals The role of the family-oriented technologies in perinatal medicine within Ural Federal District

2013 ◽  
Vol 62 (3) ◽  
pp. 44-49
Author(s):  
Galina Borisovna Malgina ◽  
Elena Pavlovna Shihova ◽  
Irina Fridrikhovna Zhukova
Keyword(s):  
Preterm Infants ◽  
Federal District ◽  
Department Heads ◽  
Personal Interview ◽  
The Urals ◽  
Perinatal Medicine ◽  
Term Infants ◽  
Perinatal Audit ◽  
The Family

The audit was conducted among leading perinatal centers of the Urals Federal District (UFD) and included department heads, doctors and patients — some by personal interview, others by written questionnaires. We found that in the perinatal centers there is virtually no organized work to prepare pregnant women for childbirth. The percentage of partnership-supported labors varies from 0 to 48.5 % (in two centers partner-supported labors do not take place at all). In most institutions partner-supported childbirth rate does not exceed 10–12 %, although the technology is available and free. Rooming-in mothers and term infants implemented everywhere, but mothers and preterm infants are often separated. Thus, it is necessary to continue the implementation of perinatal practices, namely, family-oriented technology which should be an essential indicator parameters of perinatal audit in the leading perinatal centers in the Urals Federal District.

119 Communicating Sensitive Information - An Exploration of Parental Perspectives on Prognostication of High Risk Infants

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e85-e85
Author(s):  
Emily Fong ◽  
Ronit Mesterman
Keyword(s):  
High Risk ◽  
Preterm Infants ◽  
Average Length ◽  
Sensitive Information ◽  
Neurocognitive Deficits ◽  
Biological Father ◽  
Perinatal Medicine ◽  
Term Infants ◽  
Neurologic Recovery ◽  
High Risk Infants

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Preterm infants are at high risk of experiencing a range of impairments that may contribute to long-term challenges such as neurocognitive deficits. Physicians are often expected to give an outlook on future developmental outcomes of high-risk infants, often before sufficient time has elapsed to observe whether that particular child will demonstrate neurologic recovery from the initial injury. Clinicians often struggle with communicating this information, especially a poor prognosis, because of the worry about how these conversations affect families and their future expectations of the child. Objectives Our aim was to capture parents' retrospective perceptions of how their infant’s prognosis was communicated to them during their NICU stay. Design/Methods Semi-structured interviews were conducted over the phone with parents of former preterm infants with a birthweight below 1500 grams or parents of term infants who have sustained HIE requiring cooling. Parents were invited to participate when their child was between 12-36 months old at the time of the interview, so that parents would be able to have a sense of their child’s development and possible impairments. The data was analyzed thematically, with particular focus around the discourse of communication and prognostication. Results Twenty-three interviews were conducted: 20 with the biological mother, two with both biological parents, and one with the biological father. The average length of the interviews was 30 minutes. The main themes that recurred in the interviews included parental loss of control, needing to prepare for the unexpected, the value of shared decision making between the health care practitioners and parents, recognition and conveyance of uncertainty by the physician, and the importance of celebrating the present. Above all, a recurring theme mentioned by the majority of interviewees was the power of hope. While wanting to receive transparent and honest updates, parents felt strongly that giving them realistic hope was of utmost importance. Conclusion Although clinicians often feel pressured to deliver answers, parents found it helpful when clinicians acknowledged and explained the uncertainty that surrounds prognostication. While healthcare providers may feel the need to prepare parents for the worst, the importance of balancing this information with hope and positivity is what families remember and value years after the prognosis was given.

scholarly journals Generative Strategies of Russian Men in Terms of Depopulation

2021 ◽  
Vol 20 (3) ◽  
pp. 78-86
Author(s):  
Chulpan I. Ildarhanova ◽  
Keyword(s):  
Reproductive Behavior ◽  
Family Relations ◽  
Federal District ◽  
Family Values ◽  
Value System ◽  
The North ◽  
The Family ◽  
Generative Behavior ◽  
North Western

Theoretical and methodological base of the research includes socio-demographic, thesaurus and generational approaches. Scientific and methodical base of the research is a survey held in the Volga Federal District (Republic of Tatarstan) and the North-Western Federal District (Vologda Region). This study reflects the rupture of the family thesaurus, the loss of the authoritarian value system of family relations, which leads to the leveling of responsibility, distortion of the forms of family relations, and orientation to false family values. Transmission of marital and reproductive behavior of Russian men in intergenerational aspect is analyzed on the base of the empiric survey, the role of father in comparative correlation with transmission of value heritage of fatherhood image is discovered. The scientific novelty of the study is to identify, based on the original methodology, problem areas for the implementation of various models of generative behavior of Russian men in the conditions of transformation of family and parenting institutions.

Body Composition in Very Preterm Infants: Role of Neonatal Characteristics and Nutrition in Achieving Growth Similar to Term Infants

Neonatology ◽  
2016 ◽  
Vol 111 (3) ◽  
pp. 214-221 ◽  
Author(s):  
Geneviève Tremblay ◽  
Christine Boudreau ◽  
Sylvie Bélanger ◽  
Odette St-Onge ◽  
Etienne Pronovost ◽  
...  
Keyword(s):  
Body Composition ◽  
Preterm Infants ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals The role of breast milk fortifier in the post-discharge nutrition of preterm infants

2021 ◽  
pp. 42-48
Author(s):  
Kenny McCormick ◽  
Caroline King ◽  
Sara Clarke ◽  
Chris Jarvis ◽  
Mark Johnson ◽  
...  
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Best Practice ◽  
Optimal Growth ◽  
Post Discharge ◽  
Term Infants ◽  
Community Healthcare ◽  
Fortified Milk ◽  
Bone Mineralisation

Infants born prematurely are often discharged from hospital before 37 weeks post-menstrual age. While breastfeeding will meet all the nutritional requirements of full-term infants, these preterm infants may need enhanced levels of protein, minerals and possibly energy to ensure optimum growth, bone mineralisation and neurological development. To meet these additional nutrient needs in the neonatal unit, it is currently recommended that multinutrient breast milk fortifier is added to maternal breast milk. There may also be benefits in continuing to provide fortified milk after discharge, potentially including improved growth and preserving breastfeeding, and this is increasingly becoming a recognised practice in some neonatal units. This article presents the discussion and consensus of a multidisciplinary panel of neonatologists, neonatal dietitians, a GP and a neonatal outreach sister. The aim is to develop guidance on providing safe and effective nutritional supplementation for preterm infants after discharge in order to maintain optimal growth. This guidance is aimed at community healthcare staff and is based on the limited evidence available, using shared best practice and expertise.

scholarly journals Quantitative ultrasound for the assessment of osteopenia in preterm infants

2003 ◽  
pp. 307-315 ◽  
Author(s):  
A Rubinacci ◽  
GE Moro ◽  
G Boehm ◽  
F De Terlizzi ◽  
GL Moro ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Quantitative Ultrasound ◽  
Bone Development ◽  
Ultrasound Velocity ◽  
Postnatal Period ◽  
Bone Maturation ◽  
Term Infants ◽  
Postconceptional Age ◽  
Two Parameters

OBJECTIVE: To evaluate the potential role of quantitative ultrasound (QUS) investigation in assessing the osteopenia of prematurity. DESIGN: QUS parameters measured at the time of discharge were related to the anthropometric characteristics and age (postnatal and gestational) of 51 (34 female and 17 male) preterm infants fed fortified human milk. METHODS: QUS evaluation was performed at the humerus (h) by measuring two parameters: ultrasound velocity (hSOS, in m/s) and bone transmission time (hBTT, in micros). A group of 43 term infants (29 female and 14 male) was also evaluated. RESULTS: In preterm infants, significant correlations were found for hSOS and hBTT vs gestational age (r=0.504, 0.477, P<0.0001), length (r=0.641, 0.594, P<0.0001) and weight (r=0.580, 0.562, P<0.0001) at birth, and length (r=0.341, 0.332, P<0.05) and weight (r=0.331, r=0.362, P<0.05) at QUS measurement. In preterm infants, both QUS parameters were negatively correlated with age (r=-0.536, P<0.0001, r=-0.443, P<0.001) and were significantly lower than in the term infants (hSOS: 1664+/-42 m/s vs 1734+/-28 m/s, P<0.0001; hBTT: 0.58+/-0.24 micros vs 1.06+/-0.15 micros, P<0.0001) even when adjusted for body length (P<0.05). In preterm infants, hSOS was also negatively correlated with postconceptional age (r=-0.322, P<0.05). CONCLUSIONS: This study suggests that bone mineral accrual is mainly determined by the development in utero, and that prematurity induces a halt in the bone development process in the early postnatal period. QUS parameters are correlated with the severity of prematurity and might therefore have clinical applications when bone maturation in early life needs to be determined.

Variability in Immunization Practices for Preterm Infants

2018 ◽  
Vol 35 (14) ◽  
pp. 1394-1398 ◽  
Author(s):  
Srirupa Gopal ◽  
Kathryn Edwards ◽  
Buddy Creech ◽  
Joern-Hendrik Weitkamp
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
Vaccine Safety ◽  
The United States ◽  
Perinatal Medicine ◽  
Term Infants ◽  
American Academy Of Pediatrics ◽  
Clinical Instability ◽  
Clinical Illness

Introduction The Advisory Committee on Immunization Practices and the American Academy of Pediatrics (AAP) recommend the same immunization schedule for preterm and term infants. However, significant delays in vaccination of premature infants have been reported. Objective The objective of this study was to assess the variability of immunization practices in preterm infants. Study Design We conducted an online survey of 2,443 neonatologists in the United States, who are members of the Section for Neonatal-Perinatal Medicine of the AAP. Questions were targeted at immunization practices in the neonatal intensive care unit (NICU). Results Of the 420 responses (17%) received, 55% of providers administer the first vaccine at >2-month chronological age. Most providers (83%) surveyed reported delaying vaccines in the setting of clinical illness. Sixty percent reported increasing frequency of apnea–bradycardia events following immunization. More than half administer the initial vaccines over several days despite lack of supporting data. Reported considerations in delaying or spreading out 2-month vaccines were clinical instability, provider preference, lower gestational age, and lower birth weight. Conclusion This survey substantiates the variability of immunizations practices in the NICU and identifies reasons for this variability. Future studies should inform better practice guidance for immunization of preterm NICU patients based on vaccine safety and effectiveness.

scholarly journals The role of the family in early intervention of preterm infants with abnormal general movements

Neurosciences ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Ozgun Kara ◽  
Sedef Sahin ◽  
Bilge Yardimci ◽  
Akmer Mutlu
Keyword(s):  
Early Intervention ◽  
Preterm Infants ◽  
The Family ◽  
General Movements

Silence matters: The role of pauses during dyadic maternal and paternal vocal interactions with preterm and full-term infants

2021 ◽  
pp. 1-18
Author(s):  
Eliza KIEPURA ◽  
Alicja NIEDŹWIECKA ◽  
Grażyna KMITA
Keyword(s):  
Preterm Infants ◽  
Total Duration ◽  
Full Term ◽  
Dyadic Interactions ◽  
Term Infants ◽  
Mothers And Fathers ◽  
Infant Vocalizations ◽  
Vocal Activity ◽  
Vocal Interactions

Abstract This study examined the characteristics of the vocal behaviors of parents and preterm infants, as compared to their term-born peers, at three months of age. Potential links between specific features of parental IDS and infants’ vocal activity were also sought. We analyzed the frequencies and durations of vocalizations and pauses during the dyadic interactions of 19 preterm and 19 full-term infants with their mothers and fathers. The results showed that the duration of the vocalizations was shorter for the preterm than for the full-term infants, regardless of the interactive partner. Mothers vocalized more frequently and for a longer time than fathers, regardless of the group, but only the frequency of paternal utterances was significantly and positively correlated with the frequency and duration of infant vocalizations. Frequent conversational pauses of a relatively short total duration seemed to be related to more active infants’ vocal participation, regardless of prematurity and parent gender.

scholarly journals The Use of N-Terminal-Pro-BNP in Preterm Infants

2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Afif EL-Khuffash ◽  
Eleanor Molloy
Keyword(s):  
Preterm Infants ◽  
Screening Tool ◽  
Myocardial Function ◽  
Adult Population ◽  
Ductus Arteriosus ◽  
Volume Loading ◽  
Prognostic Information ◽  
Term Infants ◽  
Neonatal Population

The use of natriuretic peptides in the neonatal population is emerging. B-type Natriuretic Peptide (BNP) and N-terminal-Pro-BNP (NTpBNP) are used in the adult population to assess myocardial function and volume loading. Their role in prognosis following cardiac surgery has also been identified. In preterm infants NTpBNP is becoming increasingly recognised as a potential screening tool for patent ductus arteriosus (PDA), and a marker for myocardial performance. In addition, NTpBNP may provide prognostic information in preterm infants and term infants with congenital diaphragmatic hernia (CDH). In this paper, the role of NTpBNP in the preterm population will be discussed.

Considerations for Touch and Massage in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Joy Browne
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Short Term ◽  
Term Infants ◽  
Developmental Care ◽  
The Family ◽  
Potential Impact

AN EXPANDING BODY OF research has documented the short-term advantages of gentle touch and massage for healthy term infants and some growing and medically stable preterm infants. These findings have provided the impetus for extension of massage techniques to very small, fragile newborns, promoting the utilization of new personnel in NICUs specifically to provide massage therapy for newborns. It is important, before engaging in these approaches, for professionals in the NICU to consider the potential impact of massage on the infant and the family. It is also imperative that professionals in the NICU take into account the current growing knowledge base regarding developmental care and the implications for decision making regarding provision of stimuli of any sort to fragile, sick newborns in the NICU.

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