Due to the fetoneonatal pathway it is possible to identify pregnant women with an increased risk of fetal growth restriction or pre-eclampsia in early stages (from 10th week of pregnancy). Women whose pregnancy is considered high-risk receives risk-adapted prenatal treatment as well as certain treatments for their newborn and infant until 1 year of age. The tasks of all involved persons are defined by standard operating procedures (SOP)
By implementing a preventive feto-neonatal pathway, healthcare for pregnant women with high risk of fetal growth restriction (FGR) or pre-eclampsia will be improved and, therefore the occurence of children's health problems may be prevented.The pathway allows healthcare to be structured, ross-sectoral, inter- and multidisciplinary in consideration of medical and psychosocial imensions. The feto-neonatal pathway transfers scientific findings, which already determine international routine care, in the project region into clinical routine care. The anamnestically increased risk for FGR or pre-eclampsia is validated by ultrasound and the identified high-risk pregnancy is attended risk-adapted from birth until the end of the first year of life of the child.As a result, the mothers' pregnancy-related risks (death, premature delivery, traumatic stress disorders) as well as risks for the child (prematurity and associated problems, childhood growth restriction with the risk of metabolic syndrome, developmental neurological problems) are reduced and the sustainability of the interventions is ensured in the long term through improved health competence of the families. The feto-neonatal pathway shows how highly specialised fetoneonatal care of high-risk pregnancies can be ensured while ensuring primary care in a health region, and offers the possibility of being extended to other indications.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
(1) early perceiving of pregnant women with higher risks for early fetal growth restrictions via color Doppler sonography, fetal biometry, haemogram check (currently additional screenings) (2) structured care of the high risk women who are pregnant (3) concerted neonatal health care (4) adapted paediatric aftercare, certain dates and responsible persons are scheduled.
Medizinische Fakultät Dresden Klinik und Poliklinik für Kinder- und Jugendmedizin / Neonatologie & Pädiatrische Intensivmedizin
Dresden, Saxony, Germany
Universitätsklinikum Jena Klinik für Kinder- und Jugendmedizin
Jena, Thuringia, Germany
Evaluation of patients' safety: maternal pre-eclampsia rate
self-designed questionnaire, health information
Time frame: through study completion, an average of 1 year and 7 months
Evaluation of patients' safety: newborn's birthweight adjusted by gestational age
self-designed questionnaire, health information
Time frame: through study completion, an average of 1 year and 7 months
Evaluation of patients' safety: maternal morbidity
self-designed questionnaire, health information
Time frame: through study completion, an average of 1 year and 7 months
Evaluation of patients' safety: infantil morbidity
self-designed questionnaire, health information
Time frame: through study completion, an average of 1 year and 7 months
Evaluation of patients' safety: Quality of life
Questionnaire: Quality of Life (Angermayer, Kilin \& Matschinger, 2000)
Time frame: through study completion, an average of 1 year and 7 months
Evaluation of patients' safety: attachment behavior
Questionnaire: Postpartum Bonding Questionnaire (Reck et al., 2006)
Time frame: through study completion, an average of 1 year and 7 months
Evaluation of patient's access to treatment and satisfaction
self-designed questionnaire
Time frame: through study completion, an average of 1 year and 7 months
claim of the health services
based on self-designed questionnaires
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828
Time frame: From admission to discharge, study inclusion to one year postpartum)
prohibition of employment
based on self-designed questionnaires
Time frame: From admission to discharge, study inclusion to one year postpartum)
duration of unemployability
based on self-designed questionnaires
Time frame: From admission to discharge, study inclusion to one year postpartum)
health economical evaluation
cost-benefit-analysis of patients' outcome in relation to supply costs based on secondary data provided by Health insurance funds
Time frame: From admission to discharge, study inclusion to one year postpartum
evaluation of ungoing processes during the fetoneontal health care pathway: target patients
based on secondary data provided by Health insurance funds
Time frame: From admission to discharge, study inclusion to one year postpartum
evaluation of ungoing processes during the fetoneontal health care pathway: effectiveness of fetoneonatal health care
based on secondary data provided by Health insurance funds
Time frame: From admission to discharge, study inclusion to one year postpartum
evaluation of ungoing processes during the fetoneontal health care pathway: participation of health care provider
based on secondary data provided by Health insurance funds
Time frame: From admission to discharge, study inclusion to one year postpartum
evaluation of ungoing processes during the fetoneontal health care pathway: implementation of participating employees
based on secondary data provided by Health insurance funds
Time frame: From admission to discharge, study inclusion to one year postpartum
evaluation of ungoing processes during the fetoneontal health care pathway: the pathway's maintenance being long term part of routine health care
based on secondary data provided by Health insurance funds
Time frame: From admission to discharge, study inclusion to one year postpartum