www.elitecme.com | 2019 | HEART HEALTH 9 just a few of the more common complications that all parents and their providers must pre- pare for as the child is born. Then there are birth defects, the most common of which are congenital heart defects. Despite their com- monality (nearly 1 in 100 babies in the United States is born with a heart defect, according to the March of Dimes), the resulting stress and anxiety on both parents and children can last a lifetime. Additionally, about 4,800 babies each year in the U.S. are born with crit- ical congenital heart disease, a grouping of the seven most severe congenital heart defects. Beyond the severity of these conditions, babies and their parents who are affected can lose out on the most intimate of moments that occur immediately after childbirth because most of these patients require an IV to start medication, umbilical catheters, an echocar- diogram, continuous EKG monitoring via wires attached to the chest, and oxygen sat- uration monitoring through a probe on their hand or foot within the first hour of life. From there, patients are transferred to the PICU in preparation for surgery followed by recovery time at the hospital that can last more than one week. ButcliniciansattheUniversityofMichigan’s C.S. Mott Children’s Hospital in Ann Arbor are taking things beyond the “typical” delivery of a baby born with congenital heart problems and attempting skin-to-skin prior to medical interventions among select infants. According to a recent report by officials with Michigan Medicine, one of the largest hospitals in the state, nurses at the hospital have played a key role in helping to enact this protocol, which has reportedly produced positive results for families that may have otherwise watched their baby receive medical interventions prior to holding and bonding with their child when such interventions could have been delayed. Michigan researchers are claiming that the implementation of a new communication strategy has found a decrease in infants who received oxygen or other potentially unneces- sary respiratory treatment immediately after delivery, from 38 to 26 percent, and that more newborns experienced maternal bonding time ahead of interventions, from 22 to 74 percent, following the communications strategy. “Parents of babies born needing heart sur- gery have a very short period of time when it’s just them and their baby, without all of the tubes and IVs and before they get transferred to the pediatric intensive care unit,” said Sarah Gelehrter, MD, a fetal cardiologist at Mott Children’s. “Our goal was to give families more time to snuggle with their baby, take photos, and just enjoy those first precious moments,” she con- tinued. “Going from a brand new baby to a car- diac patient is a huge transition, and we hope to soften the blow when we can.” According to Michigan officials, the study included 386 patients born between 2005 and 2017 who were prenatally diagnosed with ductal-dependent heart disease, a severe type of the defect that requires medication to be administered within their first few hours of life and cardiac surgery before being dis- charged home. However, these babies are not expected to be ill immediately following birth and may not appear to have heart issues at birth because they are not prenatally diag- nosed. Some babies may not be identified until a cardiac screening that is required by the state is conducted.1 For the study, the tool used by researchers incorporated standard language into patients’ medical charts, allowing cardiologists to bet- ter communicate with the delivery team about the infant’s expected course immediately fol- lowing birth, acceptable oxygen levels, and whether a brief period of bonding with par- ents was encouraged prior to initiating neces- sary treatments. The language was developed by a multidisciplinary team at Michigan Medicine that was led by Gelehrter and Naomi Laventhal, MD, a neonatologist. The team also included professionals in nursing, pediatric cardiology, obstetrics, and neona- tology, officials said. The team’s findings were presented by Ian Thomas, MD, a cardiology fellow at Mott Children’s, at the Cardiology 2019 conference, which was hosted Feb. 13-17 in Huntington Beach, CA, by the Children’s Hospital of Philadelphia. “This communication tool makes expecta- tions clear and distinguishes between babies who will likely need immediate intervention after birth from those we don’t expect will need any extra oxygen than any other baby,” said Thomas, who also noted that caregiv- ers may be prone to providing all babies who are born with heart disease the same level of respiratory interventions. The language of the communication offers the delivery team reas- surance that, in many cases, allowing families some time together before starting any inter- ventions for the baby is possible, according to Thomas. Researchers hope the tool may be consid- ered for babies born with other, non-heart related congenital abnormalities as well. “We know that maternal and family bond- ing can have big benefits for both newborns and their parents,” said Gelehrter. “Everyone wants to make sure we are taking care of these patients in the best way possible. This is a sim- ple way to help more families enjoy the new- born period and normalize what can be a very stressful hospital experience.” n Joe Darrah is a freelance author based in the Philadelphia region who has been covering the healthcare field since 2004 REFERENCES 1. Critical congenital heart disease new- born screening program. Michigan Department of Health & Human Services. 2019. Accessed online: www. michigan.gov/mdhhs/0,5885,7-339- 71550_5104_5279_63461---,00.html |  HEART DISEASE The original Physical Agent Modalities Course worth 45 contact hours. Graduates earn the CPAM® designation. 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