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The Role of the Primary Care Pediatrician in the Care of the NICU Graduate

William Sessions*, Elizabeth Waldrop, Ayo Olanrewaju, Sumesh Parat and Mubariz Naqvi

A 33 year old mother female diagnosed with twin gestation, received adequate prenatal care and all prenatal screens were negative. She took synthroid and prenatal vitamins, denied smoking, drinking alcohol, or using illicit drugs Spontaneous preterm premature rupture of membranes for Twin A at 19 weeks, admitted to the hospital at 24 weeks. Received dexamethasone, ampicillin, and erythromycin; for the preterm premature rupture of membranes. Twin A's umbilical cord prolapsed at 24 2/7 weeks; emergency cesarean section was performed to deliver both babies. Twin A, expired shortly after birth secondary to respiratory distress. Twin B developed multiple clinical problems in the NICU, many of which required intervention. Twin B's parents were very supportive and understanding and were constantly involved in the child's care during NICU stay. The mother and father participated in the discharge planning education course and roomed-in with their baby for 2 days. Twin B lost very little weight initially and regained birth weight by the 7-8th day of life and remained above the 10th percentile for weight on the growth curve. Twin B was discharged from the NICU on day 109 at post conception age 39 weeks, weighed 2834 grams (10th percentile for corrected age), measured 49 cm length (50th percentile for corrected age), fronto-occipital circumference 34 cm (50th percentile for corrected age). The patient's care was transferred to the primary care pediatrician. As for our patient, he was dismissed from the NICU 9 years ago and was followed by the high-risk clinic associated with Texas Tech Pediatrics in Amarillo for 2 years after NICU dismissal. He continues to gain weight and is progressing well. His ophthalmologist follows his visual status as he has to wear glasses for visual acuity. His broncho pulmonary dysplasia has resolved. He continues to follow up with his primary care pediatrician.