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Paeds Casesfetal-neonatal-and-perinatal

Paeds Cases · fetal-neonatal-and-perinatal

Follow-up after high-risk birth and NICU discharge — OSCE

OSCE station: counselling parents of a former extremely preterm infant at the two-year corrected-age visit about why follow-up must continue to school age despite a reassuring Bayley score, and how corrected age, sensory surveillance and educational support will be coordinated.

osce communication and management station2 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCE
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Study tools

Target exams

MRCPCH ClinicalRACP DCE
Prompt
A former 25-week, 650-gram infant is now two years corrected age with a normal Bayley-III (cognitive 95, language 92, motor 98). The parents are reassured and ask to be discharged from follow-up. The candidate must explain why follow-up should continue to school age, what corrected age means, and how sensory and educational surveillance will be coordinated.

Objectives

  1. Explain in plain language what a normal two-year Bayley score does and does not mean for a child born extremely preterm. [2] [9]
  2. Explain why follow-up must continue through school age, citing the late-emerging cognitive and behavioural burden. [2] [9]
  3. Reassure the family about the encouraging current findings while maintaining an honest, probabilistic frame about the future. [2]
  4. Outline the corrected-age follow-up plan and the sensory surveillance, and invite the family into shared understanding. [1] [7] [11]
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References6ShowHide
  1. [1]American Academy of Pediatrics Committee on Fetus and Newborn Hospital discharge of the high-risk neonate. Pediatrics, 2008.PMID 18977994
  2. [2]Marlow N, Wolke D, Bracewell MA, Samara M Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med, 2005.PMID 15635108
  3. [4]Novak I, Morgan C, Adde L, Blackman J Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr, 2017.PMID 28715518
  4. [7]Fierson WM Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics, 2018.PMID 30478242
  5. [9]Hack M, Taylor HG, Schluchter M, Andreias L Behavioral outcomes of extremely low birth weight children at age 8 years. J Dev Behav Pediatr, 2009.PMID 19322106
  6. [11]Fenton TR, Kim JH A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr, 2013.PMID 23601190
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