Hospitals Team Up to Care for Premature Infants: Evidence-Based Care Translates to Better Outcomes

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Rochford family

For as close as twins Logan and Sophie Rochford will be throughout their lives, they couldn’t have started off further apart.

On Halloween 2013, Logan arrived via a natural birth before an emergency cesarean-section was necessary to deliver Sophie 15 minutes later. Those are rare circumstances for Brent Hintz, MD,an obstetrician practicing at UnityPoint Health – Allen Hospital and a frightening time for a new mother. 

“I was there by myself,” recalled Kendra Rochford. “My husband, Neal, was at work, I had previously told my mother not to come for the birth. I had nobody except the doctors and nurses,” Rochford said. “If I did not have Dr. Hintz, we probably wouldn’t have Sophie.” 

Rochford woke up from her unexpected procedure more than three hours later to find her family had arrived and her twins were in the Neonatal Intensive Care Unit (NICU) on developmentally different paths. 

BORN PREMATURE 

Logan and Sophie were born at just over 32 weeks gestation – 35 weeks is the national average for twins. They were also discordant twins, which means the blood flow from the placenta was distributed unequally and it resulted in almost a 20 percent difference in birth weight. Both weighed less than five pounds at birth while Sophie was at a particular disadvantage as the smaller of the two. Logan was also under the care of UnityPoint Health Neonatologist Pankaj Nagaraj, MD, but mostly dealt with problems consistent with a 32-week premature baby.

 “Sophie had significant respiratory problems,” said Dr. Nagaraj. “She had low white blood cell counts, which improved over time, kidney issues, which also resolved. Routine echocardiograms were necessary to keep an eye on her heart. She was a 32-week preemie with a whole host of problems.” Rochford wasn’t able to meet her babies until the following morning. 

LIFE IN THE NICU 

Logan worked on feeding, gaining the weight necessary to be discharged and joined his one-year old sister, Olivia, at home after one month in NICU care. Sophie continued to progress at Allen Hospital’s NICU except for one complication in particular – feeding. The best she could do was three bottles per day while it takes at least twice that to be in a condition to go home. After two months, it became necessary to place a feeding tube in her stomach to ensure she was receiving the proper nutrients. 

“Being part of UnityPoint Health, we were able to send to her to a higher level NICU at UnityPoint Health – St. Luke’s in Cedar Rapids when it was necessary,” Dr. Nagaraj said. “The best part of being at Allen was we were able to fix every single problem she had except for the feeding tube.” 

Sophie also completed occupational, physical and speech therapy – services that are now available at UnityPoint Health – Prairie Parkway in Cedar Falls. “The only thing Sophie still needs is speech therapy,” said Rochford. “We’ve been through so many tests and procedures to see why she didn’t want a bottle, but other than that, you can’t tell the two apart anymore.” 

COORDINATED CARE 

After being transferred to St. Luke’s just after the New Year, Dr. Nagaraj points to standards of care between the two hospitals for what makes that transition efficient. 

“If you look at the evidence-based NICU protocols, they are updated to the month,” Dr. Nagaraj said. “We have no lag period on what we practice and what we do, which is very reflective on our outcomes.” 

Without much for an explanation, the feeding tube was inserted but never actually used because Sophie suddenly started taking the bottle on her own. She went home on February 7, 2014. 

“We’re very fortunate Dr. Nagaraj is the best NICU doctor ever,” Rochford added. “I don’t feel there’s anything we could change. That was our situation and everything turned out great.

Learn more about delivering your baby at a UnityPoint Health hospital at unitypoint.org/baby.