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Premature birth

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Premature babies have less time to fully develop and mature in the womb. As a result, they're often at increased risk of medical and developmental problems. One of the biggest problems facing premature infants is underdeveloped lungs.

Your doctor may try to delay your baby's birth if you go into labor earlier than around 34 weeks into your pregnancy (preterm labor). Even a few extra days in the womb can give your baby's lungs a chance to become more mature. But sometimes, in spite of every effort, your baby may be born early.


Treatments related to premature birth may focus on women in preterm labor, on babies still in the womb, or on newborns in hospital neonatal (newborn) intensive care units (NICUs). These may include:

For mothers
If you're experiencing preterm labor, your treatment depends on how far along you are in your pregnancy and how far your labor has progressed. Sometimes bed rest and extra fluids are enough to stop premature contractions. In other situations, your doctor may recommend certain medications. These may include some medications originally used for treating asthma, such as terbutaline (Brethaire, Brethine, Bricanyl) and ritodrine (Yutopar). These medications relax smooth muscles, including those of the uterus. Magnesium sulfate is a muscle relaxant that is given intravenously.

Medications that block the calcium channels in muscle cells can sometimes stop contractions. So can drugs that block the production of substances that stimulate uterine contractions (prostaglandins), such as ibuprofen (Advil, Motrin, others) or indomethacin (Indocin).

Medications often stop labor only for a brief period of time. They are best used to delay labor long enough to accomplish other goals, such as transferring the mother to a facility better equipped to handle premature delivery or allowing other medications to have a beneficial effect on the baby.

Although rare, preterm delivery may result from weakness of the connective tissue of the cervix with minimal pressure from uterine contractions. If this occurs, a surgical procedure known as cervical cerclage may be an option. Using strong thread, an obstetrician stitches around the cervix to close it. The thread is removed in the last month of pregnancy.

For babies in the womb
If your labor can't be stopped, you may receive medications to help prepare your baby for birth. Corticosteroids such as betamethasone can help make your baby's lungs more mature in as short a time as 24 to 48 hours.

For newborns
Hospital NICUs are designed to provide care for premature babies and full-term babies who develop problems after birth. If your premature baby spends time in an NICU, he or she will receive round-the-clock intensive care from doctors, nurses and respiratory therapists specially trained to care for newborns with medical problems.

In an NICU, your baby will probably be kept in an incubator, an enclosed plastic bassinet that is kept warm so your baby can maintain normal body temperature. Because preemies have immature skin and very little body fat, they often need extra help to stay warm.

At first your baby will likely receive fluids and nutrients — known as total parenteral nutrition (TPN) — through an intravenous catheter, and later start milk feedings through a tube that has been passed through his or her nose. Like many premature infants, your baby may not yet have developed a sucking reflex or may be too weak to suck. When your baby is stronger, you'll likely be able to feed him or her by breast-feeding or with a bottle. The antibodies in breast milk are especially important for premature infants.

Sensors may be taped to your baby's body to monitor blood pressure, heart rate, breathing and temperature. Caregivers may also use ventilators to help your baby breathe. This high-tech equipment may seem overwhelming at first, but it's all designed to help your baby.

In a hospital neonatal (newborn) intensive care unit, babies are often first watched unclothed on a warmer bed. Later your baby will probably be kept in an incubator, an enclosed plastic bassinet ...

As the parent, you play an important role in your baby's life, even though he or she is in the NICU. Your baby's caregivers will help you learn how to touch and eventually hold your baby in ways that are calming and not over stimulating. Talking or singing softly to your baby, or just providing quiet company, will give great support and comfort. When your baby is ready to eat on his or her own, the nurses will help you learn how to feed your child.

Babies are ready to go home when they no longer have medical problems that require continuous hospital care, when their body temperature is stable and when they can nurse well enough to gain weight. Your baby need not reach a specific weight or age before going home.

Before you take your baby home, your doctor will provide guidelines on how to care for him or her. Ask questions about any care issues or concerns.

Preemies are more susceptible than other newborns to serious infections, and their illnesses progress more quickly. That's why it's important that they be examined often. A follow-up visit will likely be scheduled soon after you take your baby home so that your doctor can examine the baby and answer any of your new or ongoing questions.

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