Preterm-birth Complications and Neonatal Intensive Care

Birth of a baby at or fewer than 37 weeks of gestation age and are known as preemies or premmies. Though the accurate reason of preterm birth is unknown, some of the risk factors include, diabetes, high blood pressure, being pregnant with more than one baby, vaginal infection, and psychological stress, tobacco smoking, obese or underweight. Babies born before 25 weeks of gestation age do not survive. Even if they do, they do with neural impairment for life. In case of a premature birth, the baby is kept in NICU (Neonatal Intensive Care Unit) if the baby’s health is critically unstable. If the conditions are somewhat better, the mother is asked to keep the baby warm through skin to skin contact. Breast feeding is a very crucial part for the child’s survival. Since in babies the lungs are the last organs to develop, they are given breathing support. Sometimes surfactants are used help the breathing process. Corticosteroids have also been helpful in maturation of the premature baby. The survival % is highest at 72% at 25 weeks, 55% at 24 weeks, 26% at 23 weeks and about 6% at 22 weeks.

Neonatal intensive care unit (NICU) is a specialized ICU which takes care of premature babies. The NICU not only have specialized equipment but also has specially trained nurses to take care of such babies. The NICU have a come long way in their development since their introduction in the 1960s. The NICU consists of 3 levels of care. Level 1 care contains neonates weighing more than 1800grams or with gestational age of 34weeks or more. The care consists of basic care at birth, promotion of breast feed, maintaining asepsis and provision of warmth. Level 2 contains neonates weighing 1200-1800 grams or having gestational maturity of 30-34 weeks. This level houses equipment for resuscitation, gavage feeding, phototherapy, blood transfusion, maintenance of thermo neutral environment. Level 3 contains neonates weighing less than 1200 grams or having gestational maturity of  less than 30 weeks. Such NICUs contain servo-controlled incubators, centralized oxygen, vital signs monitors, transcutaneous monitors etc.

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