Things that can happen when a baby is born extremely prematurely

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Pham Thi Yen - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital. Doctor has more than 10 years of experience in examination and treatment in the field of Obstetrics and Gynecology.
Extremely preterm birth is when a pregnant woman gives birth before the fetus is 28 weeks old. Although extremely premature babies can survive, they often have serious mental or physical health problems and require near-lifetime special medical care.

1. What is extreme preterm birth?

A normal pregnancy lasts about 40 weeks. Babies born before 37 weeks of gestation are called premature or premature babies. Babies born before the 28th week of pregnancy are considered extremely premature. The earlier a fetus is born, the less likely it is to survive. Even if they survive, extremely premature babies often face serious health problems and disabilities, sometimes lasting a lifetime.

2. Health prognosis of extremely premature babies

Now, medical advances have helped some premature babies survive and overcome health problems. However, the chance that a 28-week-old premature baby can survive without a disability is still very small. In particular, the rate of deaths of babies born before 23 weeks of pregnancy is now very rare. Although survival has increased significantly for babies born between 23 and 25 weeks of age, most of these survivors face serious, permanent disabilities. throughout the child's life. As gestational age increases, the fetal health prognosis also improves.

3. What to do when seeing signs of premature birth at 28 weeks?

The 28-week-old ultra-premature births are usually received and handled by a team of health professionals, obstetricians, pediatricians, and pediatric specialists. Pregnant women with signs of premature birth at 28 weeks should be transferred to a hospital that provides special care for extremely premature babies.
If time allows, it is best to transfer the pregnant woman to the hospital before labor. The neonatal intensive care unit (NICU) is a place that provides specialized care for babies with serious health problems, especially those born extremely prematurely. The NICU is also a place to monitor pregnant women at high risk for serious pregnancy-related problems.

4. What should be done if the baby is expected to be born extremely prematurely?

Pregnant women will work with a team of experts and doctors to create the best health care plan for both mother and fetus. This requires weighing the risks and benefits for each treatment option. A woman's decisions and wishes for her baby are also important in planning the most appropriate care.
It is important that this plan of care can be flexible depending on the circumstances. For example, your baby's care plan will often be adjusted after the baby is born, because then the doctor has more information about your baby's condition. The baby's response to treatment is also a factor that needs to be considered during pregnancy care.

5. Support resuscitation for extremely premature babies

Babies born extremely prematurely will not survive without resuscitation. Usually, resuscitation means helping the baby breathe by inserting a breathing tube. Most likely the doctor has to perform cardiac stimulation. Even with optimal resuscitation efforts, some babies born at 28 weeks of age are not likely to live. On the other hand, children who do survive will often have severe disabilities. Babies born before 23 weeks of gestation usually do not survive, even with intensive resuscitation.
In some cases, the group of doctors and the pregnant woman's family must agree on a more appropriate alternative. In such situations, your baby's medical care will focus on keeping him warm, comfortable, and pain-free.

6. Drugs that increase the survival rate of extremely premature babies

If you have had or are planning to resuscitate a 28-week-old premature baby, your doctor can give you certain medications that can improve your baby's chances of survival and reduce the risk of birth defects. These drugs include:
Corticosteroids: Support the development of the lungs and other organs in the body of premature babies. Magnesium sulfate: To reduce the risk of cerebral palsy. Antipyretics: Helps prolong pregnancy by a few hours or days to give time for the first two drugs to work. Antibiotics: To prevent infection. The use of these drugs should be considered on a case-by-case basis. For example, corticosteroids are not recommended for pregnant women whose due date falls at 22 weeks of pregnancy or earlier, because then the drug will not be effective. At 23 weeks of pregnancy, corticosteroids may be considered, but effectiveness cannot be guaranteed.

7. Risk of C-section if the baby is born very prematurely

For extremely preterm births, the possibility of a cesarean section is not necessary. However, some babies may not be in an appropriate position in the uterus for a safe vaginal delivery. In such cases, your doctor will consider a cesarean section. A cesarean section is rarely recommended before 23-24 weeks of pregnancy as this is often ineffective.

8. The impact of extremely premature birth on pregnant women's health

The decision to have a cesarean section increases the risk of complications in subsequent pregnancies. Prolonging pregnancy can worsen some pregnancy complications, such as preeclampsia, or predispose a woman to infections. Other consequences for the mother's health should also be considered before making important decisions for the woman and her unborn baby.
In all cases, a team of doctors and specialists will be with the mother to give the most appropriate medical guidance. The wishes, preferences and decisions of the pregnant woman and her family members are also important factors to be considered in the decision-making process. Because culture, values ​​and religious beliefs in a pregnant woman's life are very important to be considered before making any decision. In addition, the hospital may offer counseling services and other programs to assist pregnant women with extremely preterm labor.

9. What if the pregnant woman decides to refuse to support the resuscitation of the baby?

For babies born very prematurely, resuscitation support is considered a vital factor to increase survival. However, the mother may refuse to do so. In such cases, your baby's support measures will focus on helping your baby stay warm and comfortable.
Pregnant women can completely spend more time with their children. If desired, the nurses will help the mother preserve memories, such as taking pictures or printing footprints. In addition, the health care team will also ensure that the pregnant woman receives all the help she needs.

10. Caring for extremely premature babies

Vinmec International Hospital has saved thousands of premature babies' lives over the years. Vinmec has mastered the measures to feed extremely premature babies, being the first hospital in the North to take care of babies born 24 weeks premature. The procedures for caring and nurturing premature babies in particular and infants with pathologies in general at Vinmec bring about the same efficiency as in advanced countries, increasing the chances of babies being saved and healthy living. premature birth, increasing the chances for infertile families.
Advantages in treatment and care of premature babies at Vinmec include:
Modern equipment: Normal ventilator, high frequency ventilator, CPAP ventilator, incubator, good infection control ability, Ensure a safe environment for children
Experienced doctors and nurses. Not only taking care of premature babies, Vinmec also successfully operated and saved many babies with complex birth defects.

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