Premature birth : Causes-Symptoms-Diagnosis-Treatment
What is premature birth?
A premature birth is a birth that occurs before the baby's expected date, which is usually around the 37th week of pregnancy.
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Premature babies, especially those born very early, often have complicated medical problems. These problems can vary, but the earlier your baby is born the higher the risk of complications.
Medical terms
A preterm, premature or "preemie" baby could be a baby born too early, or regarding 3 weeks before the maturity. a standard physiological state amount (fetal development) is regarding forty weeks. Preterm birth happens at thirty seven weeks or earlier. This premature or early birth will cause serious health risks to the mother and baby.
About one out of each ten births within the U.S. is premature. the amount will increase in lower-income countries. Complications from premature births are the leading reason for death in kids younger than five.
Babies born too early are at a higher risk for health problems Premature birth -- defined as birth prior to 37 weeks of pregnancy -- is the leading cause of infant mortality in the United States accounting for nearly 12% of all infant deaths And according to a new report from the U.S Centers for Disease Control and Prevention (CDC) preterm birth rates continue to increase in more than half of states across our country
: Causes risks and effects Premature babies may have to face several types of difficulties in life right from learning new things to physical activities While experts are yet unsure about the long-term effects that prematurity can cause on the child's brain functioning or its growth and development there seems to be enough evidence collected so far to prove that it is not good for a premature baby to stay in an incubator for a longer time period
Babies born prematurely may have different conditions than babies born at a normal time.
Late preterm,A baby is born between 34 and 36 completed weeks after conception.
Moderately preterm,A baby is born between 32 and 34 weeks after conception.
Very preterm, born at less than 32 weeks of pregnancy
Extremely preterm, born at or before 25 weeks of pregnancy
Most premature births happen in the late stage before the baby is fully developed. This means that the baby is born before 37 weeks of pregnancy.
Symptoms Premature birth
Your baby may have mild symptoms of premature birth or may experience more-obvious complications.
Some signs that a baby is premature include the following:
The head of this plant is large compared to its body.
Your baby's features will be more angular than a full-term baby since the baby doesn't have as many fat stores.
lanugo is a layer of hair that covers much of the body during early development.
After giving birth, a woman's body temperature is usually low because there is not as much stored fat.
Respiratory distress means that the person is having trouble breathing.
Feeding difficulties may result from a lack of reflexes when sucking and swallowing.
The following tables show the median birth weight and head circumference for premature babies of different gestational ages for each sex.
Which is special.
If you deliver a preterm baby, your baby will likely need a longer stay in the hospital's special nursery unit. Depending on how much care your baby requires, he or she may be admitted to an intermediate care nursery or the neonatal intensive care unit (NICU). Doctors and a specialized team will be working closely with your baby during his or her stay. There will be people on hand who know how to take care of premature babies. If you have any questions, don't hesitate to ask.
Your baby may need extra help feeding and adjusting after delivery. Your health care team can help you understand what is needed and what your baby's care plan will be.
Risk of Premature birth
It is not always clear why some babies are born prematurely.There are some things that can increase the risk of premature delivery, including: -Having a family history of premature birth -Being pregnant during a time of stress or illness -Smoking cigarettes or using other tobacco products
Having a previous premature birth
Having twins or more multiples during pregnancy is triple the work.
Pregnancies should not be spaced more than six months apart.
In vitro fertilization (IVF) is a process that allows two people to conceive a child through their own sperm and eggs.
If there are problems with the uterus, cervix, or placenta, that can interfere with the baby's growth or development, those problems may need to be addressed.
Smoking cigarettes or using illicit drugs is not healthy for you.
Some infections can occur in the area around the amniotic fluid and lower genital tract.
Chronic conditions such as high blood pressure and diabetes can develop over time.
Being underweight or overweight before becoming pregnant can have negative consequences for the baby.
Stressful life events, such as the death of a loved one or domestic violence, can be difficult.
Multiple miscarriages or abortions
Physical injury or trauma
Black women are more likely to have premature births than are women of other races, but premature birth can happen to anyone. In fact, many women who have a premature birth have no known risk factors.
Complications Premature birth
Premature babies can experience complications when they are born too early, including short-term and long-term health problems. Generally, the earlier a baby is born, the higher the risk of complications. Birth weight is also important.
Some problems may be evident at birth, while others may not develop until later.
Short-term complications
In the early weeks after premature birth, complications may include:
- Breathing difficulties.Premature babies may have trouble breathing because their respiratory system is still developing. If the lungs don't have enough surfactant, which helps the lungs expand and contract, the baby may develop respiratory distress syndrome.Premature babies may also develop a lung disorder known as bronchopulmonary dysplasia. Some preterm babies may experience prolonged pauses in their breathing known as apnea.
Heart problems. Premature babies are most commonly diagnosed with heart problems called patent ductus arteriosus and low blood pressure. PDA is a persistent opening between the aorta and pulmonary artery. If left untreated, it can lead to a heart murmur and heart failure. Low blood pressure can sometimes require changes in intravenous fluids, medications, and sometimes blood transfusions.
Brain problems.Babies born earlier have a greater risk of developing an intraventricular hemorrhage, which is a bleed in the brain. Most bleeds are mild and will go away on their own, but there is a small chance that a baby may develop more serious brain bleeding. If this happens, the baby may experience significant long-term damage.
- Temperature control problems. Premature babies can lose a lot of body heat quickly. They don't have as much stored body fat as full-term infants and they can't generate enough heat on their own. If body temperature dips too low, an abnormally low core body temperature (hypothermia) can happen. Decoupage may result in some unintended effects.Premature babies can become cold and suffer from breathing problems and low blood sugar levels if they are not warm enough. In addition, premature infants may need extra warmth until they grow stronger and can regulate their own body temperature on their own. Some types of plants are larger and can survive without assistance.
Gastrointestinal problems. Premature infants are more likely to have immature digestive systems, which can lead to complications such as necrotizing enterocolitis. This potentially serious condition in which the cells lining the bowel wall are injured can occur in premature babies after they start feeding. Babies who are exclusively breastfed have a much lower risk of developing necrotizing enterocolitis.
- Blood problems. Premature babies are at risk of blood problems such as anemia and newborn jaundice. Anemia is a condition in which the body doesn't have enough red blood cells. While all newborns experience a slow decline in red blood cell count during the first few months of life the decrease may be greater in premature babies. Newborns who are premature.Newborn jaundice is a yellow discoloration in a baby's skin and eyes that results from an excessive amount of bilirubin, a yellow-colored substance from the liver or red blood cells. Bilirubin is common in preterm babies, and it can cause jaundice.
Metabolism problems. Some premature babies have problems with their metabolism. This can happen because premature infants typically have smaller stores of stored glucose than do full-term babies. Premature babies also have more difficulty regulating their blood sugar levels. It is difficult for the body to convert stored glucose into more-usable forms of energy.
Immune system problems.A premature baby's undeveloped immune system increases the child's risk of infection. Infection can quickly spread through the child's bloodstream, leading to sepsis, an infection that spreads through the bloodstream.
Long-term complications
Premature birth can lead to complications over time, such as:
Cerebral palsy.Cerebral palsy is a disorder that can occur as a result of movement problems, muscle weakness, or poor posture. It can be caused by infection, inadequate blood flow, or injury to the baby's developing brain before birth or during infancy.
Impaired learning.Babies who are born prematurely tend to lag behind their full-term counterparts in various developmental milestones. Upon school age, a child who was born prematurely might have learning disabilities.
Vision problems. Premature infants may develop retinopathy of prematurity, a disease in which blood vessels swell and cover the back of the eye's light-sensitive layer. Sometimes the abnormal vessels gradually scar the retina, pulling it out of its normal position. If this happens to a premature infant's retina, he or she may have difficulty seeing. If retinal detachment is detected at the back of the eye, this can impair vision and lead to blindness.
Hearing problems.Babies who are premature are at an increased risk of some degree of hearing loss. All babies will have their hearing checked before they leave the hospital. If a baby's hearing is impaired, he or she will be given special instructions to help him or her function as normally as possible.
Dental problems.Infants who have been critically ill are at an increased risk of developing dental problems, such as delayed tooth eruption, tooth discoloration, and improperly aligned teeth.
Behavioral and psychological problems can occur.Children who were born prematurely may have a number of behavioral or psychological problems as well as developmental delays.
Chronic health issues. Premature babies are more likely to have chronic health issues than full-term infants. Some of these issues may require hospital care, such as infections, asthma, and feeding difficulties. Premature infants also face a greater risk of sudden infant death. SIDS is a syndrome in which babies die from sleeping in the same bed as their parents.
Can premature birth be stopped?
Even with increased awareness the rate of preterm birth is still growing And while there are many factors contributing to this trend one of the most important things we can do as a society and a medical community is to educate pregnant women about the benefits of seeking treatment for health issues during pregnancy By eliminating unnecessary stress and taking care of themselves as early in pregnancy as possible mothers-to-be decrease their risk for preterm birth.
As a woman ages the risk of having a premature baby increases Women in their late 30s or early 40s are at high risk A woman who has had a previous delivery prematurely is also at higher risk to deliver prematurely again In addition certain medical conditions can increase a woman’s chances of delivering prematurely Examples include thyroid problems autoimmune disorders lupus and uterine infections such as chlamydia and gonorrhea Smokers are also at greater risk for premature birth than nonsmokers because smoking harms the placenta and umbilical cord.
Premature birth occurs when a baby is born too soon before 37 weeks of pregnancy Most babies are born between 40 and 42 weeks of gestation A premature birth can be dangerous for the baby because he or she may not yet have fully developed in the womb and has less time to develop fully before birth There were about 1 million premature births in the U.S in 2010 according to the Centers for Disease Control and Prevention (CDC) Premature babies face an increased risk of health problems such as respiratory distress syndrome jaundice feeding difficulties and brain hemorrhages.
Can bed rest prevent preterm labor?
There is no medical evidence to support the idea that bed rest prevents preterm labor In fact lying or sitting in one position for extended periods of time can increase pressure on the cervix and directly stimulate contractions Being active such as walking around is actually good for you during pregnancy because it helps stabilize your blood pressure and keeps you healthy by improving circulation If you're experiencing pain either from a contraction or a condition called SPD (Symphysis Pubis Dysfunction) use safe techniques like changing positions frequently or using heat packs.
What foods cause preterm labor?
Pregnant women should be aware of which foods and beverages can lead to premature labor Although many things can cause preterm labor including medical conditions certain foods contain known stimulants that may induce the onset of contractions The following are possible causes of preterm labor.
How can I move my placenta naturally?
Step 1 Get into a comfortable position You might want to sit or lie down Make sure you can comfortably reach your placenta and your anus which is where the placenta will pass once it detaches from the uterus Step 2 Keep moving around so that your body doesn’t go numb and you can feel when the placenta passes through your opening If you do go numb for too long make sure to put some pressure on the area until feeling returns If it doesn’t return after several minutes you should call your doctor immediately or go to the nearest urgent.
Prevention Premature birth
Preterm birth can happen for many reasons, but some things that might help reduce a woman's risk include:
Progesterone supplements.Women who have a history of preterm birth, a short cervix, or both factors may be able to reduce the risk of preterm birth by taking progesterone supplements.
- Cervical cerclage.This is a surgery that is performed during pregnancy in women who have a short cervix or who have had a preterm birth before.During this procedure, the cervix is closed with strong stitches that may provide extra support to the uterus. The stitches are removed when it's time to deliver the baby. Make sure to avoid any vigorous activity during the remainder of your pregnancy.
Diagnosis Premature birth
After your premature baby is moved to the NICU, he or she may undergo a number of tests. Some tests are ongoing, while others may be performed only if staff suspect a complication.
Some tests that may be done for your premature baby include:
Breathing and heart rate monitor.Baby's breathing and heart rate are monitored continuously. Blood pressure readings are done frequently, too.
Fluid input and output.The NICU team watches how much fluid your baby takes in through feedings and intravenous fluids, and how much fluid the baby loses through wet or soiled diapers.
- Blood tests. A blood sample is collected from your baby by inserting a needle into a vein in the heel, or by taking a blood sample through a vein on the back of your baby's hand. The sample may be analyzed for levels of calcium, glucose, and bilirubin, as well as to measure the red blood cell count and look for anemia. To treat an infection, use medicine.If the doctor expects to take several blood samples from your baby in the hospital, they may put a central intravenous line in your baby's vein. This way, they will not have to prick your baby multiple times.
Echocardiogram.This test uses sound waves to see if your baby's heart is working correctly. Like a fetal ultrasound, it produces moving images on a display monitor.
Ultrasound scan.Ultrasound scans can be used to examine the brain for bleeding or fluid buildup, as well as the abdominal organs for problems in the gastrointestinal tract, liver or kidneys.
Eye exam.An ophthalmologist (eye doctor) may examine your baby's eyes and see if there are any problems with the retina (retinopathy of prematurity).
If your baby has any complications, other specialized testing may be needed.
Treatment Premature birth
The neonatal intensive care unit (NICU) is a place where your premature baby receives round-the-clock care.
Supportive care
Specialized care for your baby may include: - providing warmth - keeping the baby comfortable - supplying milk or formula if needed
Being placed in an incubator.Your baby will probably stay in a plastic bassinet that's kept warm. Later on NICU staff may show you a special way to hold your baby — known as kangaroo care — where the baby's skin is in direct contact with yours.
Watch your baby's vital signs to make sure they are stable.A sensor may be taped to your baby's body to monitor blood pressure, heart rate, and breathing. If needed, a ventilator may be used to help your baby breathe.
Having a feeding tube. At first your baby will receive fluids and nutrition through an intravenous (IV) tube. Later, breast milk may be given through a tube that is passed through your baby's nose and into their stomach (nasogastric or NG tube). When your baby is strong enough to nurse or drink from a bottle, this will happen. It is usually possible.
Replenishing fluids. Your baby needs a certain amount of fluids each day, depending on his or her age and medical condition. The NICU team will closely monitor fluid levels to make sure that your baby's target levels are met. If fluids are needed, they will be delivered through an IV. draw a line.
Spending time under bilirubin lights. If your baby has infant jaundice, you may place them under a set of lights called bilirubin lights for a period of time. The lights help the baby's system break down excess bilirubin, which builds up because the liver can't process it all. A baby will wear a protective eye mask to rest more comfortably.
Receiving a blood transfusion.Your preterm baby may need a blood transfusion in order to increase blood volume - especially if several blood samples have been drawn for various tests.
Medications
Your baby may receive medications to help them mature and stimulate normal function in the body organs. This could involve medications that influence growth, breathing, and circulation. Depending on your baby's condition, medication may include specific treatments.
Respiratory distress syndrome is treated with a medication called a surfactant.
Medication to strengthen breathing and heart rate can be delivered in a fine mist (aerosolized) or intravenously.
If you think you may have been infected with something, or if there is a risk of infection, take antibiotics.
Medicines that increase urine output (diuretics) are used to manage excess fluid.
A doctor will give you medication to stop the growth of new blood vessels in your eyes that could lead to retinopathy of prematurity.
Medicine that helps close a heart defect known as a patent ductus arteriosus.
Surgery
Sometimes surgery is necessary to treat a number of health conditions that are common in premature babies. Talk with the team who will be caring for your baby about which complications may require surgery and find out about the type of surgery that may be needed.
Taking your baby home
Your baby is ready to go home when he or she: -Is old enough to travel without being supervised closely by a parent or guardian -Is able to calm down and rest after being away from home
Can breathe without support
Can maintain a stable body temperature
Can breast- or bottle-feed
Is gaining weight steadily
Is free of infection
If a child meets one of the medical requirements, the parent can allow the child to go home as long as a care plan is created and approved by the medical team.
Your baby's health care team will help you learn how to take care of your baby at home. Before leaving the hospital, your baby's nurse or a hospital discharge planner may ask you some questions about:
Living arrangements
Other children in the household
People who are related to you or who you know well can help care for your baby.
Primary pediatric care
Lifestyle and home remedies
You might feel relieved, excited, and anxious when you finally bring your baby home from the hospital. Consider what preparations you will need to make for life with your baby after you leave the hospital:
- Understand how to care for your baby.Before leaving the hospital, make sure to take a course in infant CPR. Ask your baby's medical team any questions you may have and take notes.Make sure you are prepared to care for your baby if necessary, especially if there are any medications or special equipment that you will need to use. Talk with your baby's doctor about any symptoms that might require a call. The person who is taking care of your baby.
Discuss feedings. Talk to the medical team about your baby's need for supplemental feeding. Premature babies usually eat less and may require more frequent feeding than full-term babies. Find out how much and how often your baby should be fed. Eating.
- Protect your baby's health. Premature babies are more likely to get serious infections than other newborns. Try to keep your baby away from crowded places and make sure everyone who comes into contact with your baby washes their hands first. If someone is ill, ask them to postpone their visit until they have cleaned themselves up. This means that...Preventing a serious infection of the lungs and respiratory tract (respiratory syncytial virus or RSV) might be advised for premature babies by their doctor, in case they are at high risk. This medication (palivizumab, Synagis) helps protect your baby from this infection.
Make sure to have regular checkups by following a recommended schedule.Talk to your baby's care provider and any specialists about your baby's future appointments. Preterm babies may initially need to see their care provider (and any specialists) every week or two to monitor their growth.
- Stay on top of vaccinations.It is common for babies to receive their immunizations at different ages than expected, based on their chronological age. Work with your baby's health care provider to stay up-to-date on your baby's vaccinations.You can protect your preterm infant by making sure that everyone in the home is up to date on their immunizations, including influenza. Pregnant women and family members of pregnant women should also check with their doctors to be sure they're up to date on whooping cough. A vaccine is a medicine that helps the body fight a virus.
Monitor for developmental delays.Your baby's care provider will monitor your baby for developmental delays and disabilities in the coming months. If your baby is identified as at risk, he or she may receive further evaluation and be referred to early intervention services that vary by state.
Coping and support
Caring for a premature baby can be challenging. You may be anxious about your baby's health and whether they will have any long-term effects from being born prematurely. You may feel angry, guilty, or overwhelmed.
Some things that may make this tough time a little easier: -Take some time to relax and enjoy your favorite things -Try to get enough sleep -Talk to someone you trust about how you're feeling
Make sure you know as much as possible about your baby's condition.Talk to your baby's doctor and other care providers about your questions and concerns. Ask for informational pamphlets and recommendations for good books and reliable websites that will provide more information about taking care of your preterm baby.
Take care of yourself.Get enough sleep and eat healthy foods. You'll feel better and be able to take care of your baby better if you do.
Establish your milk supply.Until your baby is able to breastfeed, use a breast pump. Ask the hospital staff for help. They can show you how to use the pump and provide you with supplies to store milk.
Accept help from others.Invite friends and family to help you with household tasks so you can focus on caring for your new baby. This will help you save your energy.
Keep a journal.Write down your baby's progress and your own thoughts and feelings as they happen. You can include pictures of your baby to show how much he or she changes from week to week.
Seek good listeners for support. Talk to your family, friends, and caregivers. The NICU social worker can be very helpful. If you're interested, your baby's caregivers may be able to suggest a support group in your area. Many parents find it particularly helpful to talk to others who are going through the same thing. Who is caring for a preterm infant?
Caring for a baby is a great challenge. Just take it one day at a time. Despite the worries and setbacks, be grateful for the surprising resilience and strength of your preemie and treasure the time you can spend getting to know your son or daughter.
Making sure you are prepared for your appointment.
You'll be interacting with many different care providers for your baby, who will include members of the NICU team. These caregivers will be responsible for your baby's care in the NICU.
Neonatal nurse —A registered nurse who has special training in caring for premature and high-risk newborns is a person who has been trained to help these babies.
Neonatal nurse practitioner —A neonatal nurse with experience caring for newborns will assist a neonatologist.
Pediatrician —A doctor who is specialized in treating children from birth through adolescence
Neonatologist —A pediatrician is someone who is specially trained to treat newborn health problems.
Pediatric resident —A doctor who is specially trained to treat children is a doctor who is receiving specialized training.
Respiratory therapist —A respiratory care practitioner who evaluates newborn respiratory problems and provides management of respiratory equipment
Pediatric surgeon —A surgeon who specializes in performing surgery on newborns and children is a doctor.
A pediatric social worker helps children who have problems.A professional who can help you find services that will be useful during and after your baby's hospital stay.
Besides these health professionals, you are also an important part of the care your baby receives. Ideally, you will work in collaboration with your baby's care providers eventually learning how to hold and feed your baby.
What you can do
Some things in the NICU can be scary - like seeing monitors and other types of equipment. Ask questions about your baby's condition and get answers when you're ready. For example, you might want to ask:
What is my baby's condition? Has anything changed since I last checked?
How does this equipment help my baby?
Why are you giving my baby medication?
What types of tests does my baby need?
Can I hold my baby now? Will you show me how?
How long will my baby have to continue receiving feeding tubes?
When should I begin to breast- or bottle-feed my baby?
When will my baby be able to focus on things?
If you have any questions about caring for your baby, who should you contact?
Can I bring in personal items such as a blanket or photos of my family to make the incubator feel more like home for my baby?
What can I do to make sure my baby is well-cared for while he or she is in the NICU?
When will my baby be able to come home?
What should I do once we're home with our baby?
After discharge, how often will we need to come back for check-ups?
During your baby's stay in the NICU, do not hesitate to ask the staff what you can do to become more involved in your baby's care. Being hands-on with your baby can give you a sense of confidence as a new parent, as well as make the transition home a little easier.
General summary
Premature babies who are born before the 37th week of pregnancy need special care. They are usually admitted to a neonatal intensive care unit (NICU) There they receive many forms of treatment.