Follow up observation

What is follow-up observation?

Post-discharge treatment of a premature baby can last more than just one month, but sometimes even years. There are high risks of disability in infants born prematurely, lack of data between the morbidity of newborns and long-term outcomes of treatment.

Follow-up observation programs allow to minimize motor and cognitive disorders in premature babies. This is the very first thing that is a prerequisite for creating a follow-up observation of newborns at risk during the first year of life.

The follow-up observation room is a structural unit operating as part of a level III perinatal center or a multidisciplinary hospital. To date, there is no approved protocol for what a follow-up observation center for prematurely born infants should look like.

Follow-up rooms were agreed to help detect deviations and possible disorders in the infant's development (motor ability, hearing, vision, sleep, vigilance, attention, speech) in a timely manner and to provide a scheme of treatment, consultations and studies, rehabilitation measures in the early stages. There is also development monitoring in the main five areas of development: motor, cognitive, sensory, social-emotional and communication; monitoring and correction of somatic disorders; informing parents and involving them in the processes of the infant's development.

The infant's development is assessed at the key ages of 3, 6, 9, 12, 24 and 36 months, guided by the appropriate scales and screenings recommended by the Ministry of Health. After reaching the age of three years, follow-up observation stops.

Who should send to the follow-up center?

Before the baby’s discharge from the NICU, the neonatologist should establish the presence or absence of grounds for conducting a follow-up observation of the infant.

During which the physician determines whether the infant belongs to the medium or high risk group.
The risk group includes neonates who have at least one of the following signs:

• gestational age at birth of 35 weeks to full 37 weeks and/or body weight of 2000 g to 2500 g;
• mild neonatal encephalopathy;
• neonatal jaundice that required phototherapy;
• intraventricular hemorrhage.
• gestational age at birth of 28 weeks to full 37 weeks and/or body weight of 500 g to 2500 g;
• a baby from a multiple pregnancy;
• neonatal encephalopathy;
• transient hypoglycemia;
• neonatal sepsis;
• hyperbilirubinemia, which required replacement blood transfusion;
• artificial ventilation of the lungs lasting up to 72 hours,
• conducting therapeutic hypothermia;
• condition after surgical/neurosurgical intervention and/or the need for further surgical/neurosurgical follow-up and intracranial hemorrhages (in the brain parenchyma);
• necrotizing enterocolitis;
• persistent prolonged hypoglycemia;
• convulsions;
• neuroinfections;
• shock requiring inotropic/vasopressor support;
• birth in HIV-infected mothers;
• feto-fetal transfusion syndrome;
• neonatal bilirubin encephalopathy;
• severe developmental defects;
• congenital metabolic/genetic disorders;
• abnormal neurological examination results at discharge.

Rules of registration in the follow-up centers
The examination in the follow-up room is carried out by appointment; you need to contact the person in charge.

Payment for the services of the follow-up centers
The follow-up center works for free, which is guaranteed by the National healthcare service of Ukraine, the medical guarantee program.

How long does one need to visit the follow-up center?
Up until the child is age of 3 years old