Abstract
BackgroundPrematurity escalates the crisis of the infants a susceptible group of the society. Multiple delivery further intensifies the susceptibility of both family and health system. A comprehensive care is, thus, necessary to ensure the optimal growth and development of such multiple-births. Accompanied by trainings, challenges, and strategies, the present study was conducted based on a two-year report of comprehensive care management experience on two sets of multiple infants.MethodsA qualitative case study approach was used to survey these two sets of premature infants (quadruplet and quintuplet) and their families. The data were collected through medical files, interviews, questionnaire, field presence, phone call and WhatsApp application, and continued follow-ups. Content analysis was performed based on survey and interventions during a period of two years in Isfahan, Iran (2018–2020).ResultsCase presentation and comprehensive care management are the main areas resulted from this study. The results of the study were categorized in eight challenging areas (categories) and strategies including sterility and infertility period, transition from the intrauterine to neonatal intensive care unit (NICU), discharge process, physical and developmental status, home visit and home care, development of care plan, socio-economic support, and coronavirus nightmare.ConclusionBased on challenges and strategies during these two years, the situation of the multiple-birth infants and their families’ needs should be identified as the first prerequisites in an inter-professional approach and in collaboration with the health providers. Isfahan University of Medical Sciences, Welfare Organization, and the charities were the parties involved with this process in our study. It was also found that developing a separate specific package of comprehensive care management plan for multiple-births is a necessity.
Highlights
Prematurity escalates the crisis of the infants a susceptible group of the society
In a 7-years prospective study conducted in Amin hospital in Isfahan, Iran, it was shown that 280 deliveries of total 18,790 deliveries were twins, of which 68% were same sex and 31.9% opposite sex (28.5% boys and %39.4 girls)
Study design A qualitative study was conducted to survey the infants’ comprehensive care management plan deeply and accurately, enabling the researchers to review a complex phenomenon in a real field
Summary
Prematurity escalates the crisis of the infants a susceptible group of the society. Multiple delivery further intensifies the susceptibility of both family and health system. Accompanied by trainings, challenges, and strategies, the present study was conducted based on a two-year report of comprehensive care management experience on two sets of multiple infants. The risk of multifetal pregnancy and premature delivery has recently been increased through using advanced fertility technology, assisted reproductive technologies, and other fertility treatments. In a 7-years prospective study conducted in Amin hospital in Isfahan, Iran, it was shown that 280 deliveries of total 18,790 deliveries were twins, of which 68% were same sex and 31.9% opposite sex (28.5% boys and %39.4 girls). Another study conducted in Rasht, a city in north of Iran, indicated that 7% of the deliveries were twins [4]. Encompassing the high risk pregnancies, the study surveyed the outcomes and experiences related to multifetal deliveries from admission up to the discharge during a period of three years. There was no significant difference between survival rate of multiple births and that of the twins [5]
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