Baby survival at 32 weeks
Survival Rate, Time in Hospital, More
The final months of pregnancy are full of prepping and planning. And, of course, planning is important. But be prepared: Many births don’t go according to plan.
For example, you might end up having a cesarean delivery (C-section) or other interventions that you weren’t planning on. Or you may find yourself with much less time to prepare if your baby decides to show up to the party earlier than expected!
About 11 percent of babies worldwide are born early (premature). This means that they’re born more than 3 weeks before their estimated due date. About 85 percent of these are born between 32 and 36 weeks of pregnancy.
But if your baby is born even more prematurely — say, at 32 weeks — they still have very good odds at being healthy with some supportive medical care. Here’s what you need to know about a baby born at 32 weeks.
Yes, a baby can safely be born at 32 weeks, but they may need specialized care to help support their development as they navigate their early days in the world.
A baby who’s born before week 37 of pregnancy is considered to be premature. However, during pregnancy, every week — and even every day — makes a difference in a baby’s growth and development. This is why premature babies are grouped into four stages:
- late preterm, born between 34 and 36 weeks
- moderate preterm, born between 32 and 34 weeks
- very preterm, born between 25 and 32 weeks
- extremely preterm, born before 25 weeks
If your baby reaches 32 weeks of gestation (time in the womb) and is born at 32 weeks, they’re moderate preterm. Babies born at 32 weeks have a survival rate as high as 95 percent. They also have very good chances of growing into healthy babies and children without any complications.
Babies who are born very preterm and extremely preterm have a higher risk of complications and health problems than a baby born at 32 weeks.
How healthy and developed your baby is at 32 weeks also depends on what kind of pregnancy you have. If you’re carrying twins or other multiples they may be smaller than if you’re carrying a singleton baby.
At 32 weeks, babies still have a couple months to go before reaching their full birth weight, but they’re well developed. Your baby will look almost like a full-term baby, just smaller, thinner, and even more delicate.
They’ll have almost-there toenails and perhaps a few wisps of hair on their head. Most of the soft, downy hair (lanugo) that covered them earlier in the womb will have started falling off, but they’ll still be a little fuzzy.
They probably will not yet have fully formed fingernails. Their eyes, though developed, may be too sensitive to light to open just yet. By 32 weeks most babies are practicing breathing, and their lungs are in the final stages of development. Their skull and all their bones will still be very soft.
At 32 weeks, a baby may:
- weigh almost 4 pounds
- be between 16 and 17 inches long
- have a head size (circumference) between 11 and 12 inches
How long your baby needs to stay in the hospital after they’re born at 32 weeks depends on several things.
After birth, your premature baby will be taken to a special care nursery or the neonatal intensive care unit (NICU) in the hospital where you gave birth.
Most babies born at 32 weeks of pregnancy have only a few temporary health issues and need to stay in the NICU for only a few days to a few weeks. After birth, your baby may need extra help learning and developing the skills needed for feeding, staying warm, and breathing on their own.
Babies born at 32 weeks will generally not yet be strong enough to breastfeed because their sucking muscles are still weak and uncoordinated. They’ll likely need to be tube-fed for a few weeks.
That said, receiving breast milk is especially important for preterm babies. Compared to preterm babies who receive formula, those who receive human milk typically have higher survival rates, shorter NICU stays, and fewer serious health complications.
Even if you weren’t planning to breastfeed, you may consider expressing milk to help nourish your premature baby. You may also consider donor milk.
Most babies born at 32 weeks don’t have breathing problems, but your doctors and nurses will make sure they’re breathing properly.
Before your baby can safely go home with you, your doctor will make sure they don’t have any other health problems and are growing and developing enough to do well without NICU care.
Before they’re discharged, your baby will be evaluated on their:
- weight gain
- ability to suck and swallow milk on their own
- temperature regulation
- eye development and sensitivity
Babies born at 32 weeks might have some temporary health problems such as:
- low birth weight
- jaundice
- hypothermia
- feeding difficulties
Some long-term issues in babies born at 32 weeks might show up months to years later. These are not common, but can include slower development. In most cases, babies with learning or developmental delays catch up later in childhood with a little bit of extra help.
A 2017 medical study in France that followed 5,170 babies who were born between 22 to 34 weeks of pregnancy found that babies born at 32 to 34 weeks had very low risks of long-term health problems.
The researchers found that about 1 percent of babies born at 32 to 34 weeks had the neuromotor disorder cerebral palsy.
The same study tested 2,506 2-year-olds who were born prematurely. In the group born at 32 to 34 weeks of pregnancy, 36.2 percent scored slightly lower than average on a questionnaire that was used to test brain development.
While this means that some babies born at 32 weeks may have delayed learning development and skills in early childhood, and early intervention can have a significant impact in improving skills.
If your baby is born at 32 weeks, they have very good chances of being born healthy and developing just fine.
They’ll be considered premature, specifically moderately preterm, and will need extra medical care to make sure they’re healthy and growing normally before they can go home. Your baby may be in the hospital or NICU for several days to weeks.
In rare cases, a baby born at 32 weeks may have neurodevelopmental (brain and learning) delays. In most cases, they’ll catch up with some extra help during early childhood.
Survival Rate, Time in Hospital, More
The final months of pregnancy are full of prepping and planning. And, of course, planning is important. But be prepared: Many births don’t go according to plan.
For example, you might end up having a cesarean delivery (C-section) or other interventions that you weren’t planning on. Or you may find yourself with much less time to prepare if your baby decides to show up to the party earlier than expected!
About 11 percent of babies worldwide are born early (premature). This means that they’re born more than 3 weeks before their estimated due date. About 85 percent of these are born between 32 and 36 weeks of pregnancy.
But if your baby is born even more prematurely — say, at 32 weeks — they still have very good odds at being healthy with some supportive medical care. Here’s what you need to know about a baby born at 32 weeks.
Yes, a baby can safely be born at 32 weeks, but they may need specialized care to help support their development as they navigate their early days in the world.
A baby who’s born before week 37 of pregnancy is considered to be premature. However, during pregnancy, every week — and even every day — makes a difference in a baby’s growth and development. This is why premature babies are grouped into four stages:
- late preterm, born between 34 and 36 weeks
- moderate preterm, born between 32 and 34 weeks
- very preterm, born between 25 and 32 weeks
- extremely preterm, born before 25 weeks
If your baby reaches 32 weeks of gestation (time in the womb) and is born at 32 weeks, they’re moderate preterm. Babies born at 32 weeks have a survival rate as high as 95 percent. They also have very good chances of growing into healthy babies and children without any complications.
Babies who are born very preterm and extremely preterm have a higher risk of complications and health problems than a baby born at 32 weeks.
How healthy and developed your baby is at 32 weeks also depends on what kind of pregnancy you have. If you’re carrying twins or other multiples they may be smaller than if you’re carrying a singleton baby.
At 32 weeks, babies still have a couple months to go before reaching their full birth weight, but they’re well developed. Your baby will look almost like a full-term baby, just smaller, thinner, and even more delicate.
They’ll have almost-there toenails and perhaps a few wisps of hair on their head. Most of the soft, downy hair (lanugo) that covered them earlier in the womb will have started falling off, but they’ll still be a little fuzzy.
They probably will not yet have fully formed fingernails. Their eyes, though developed, may be too sensitive to light to open just yet. By 32 weeks most babies are practicing breathing, and their lungs are in the final stages of development. Their skull and all their bones will still be very soft.
At 32 weeks, a baby may:
- weigh almost 4 pounds
- be between 16 and 17 inches long
- have a head size (circumference) between 11 and 12 inches
How long your baby needs to stay in the hospital after they’re born at 32 weeks depends on several things.
After birth, your premature baby will be taken to a special care nursery or the neonatal intensive care unit (NICU) in the hospital where you gave birth.
Most babies born at 32 weeks of pregnancy have only a few temporary health issues and need to stay in the NICU for only a few days to a few weeks. After birth, your baby may need extra help learning and developing the skills needed for feeding, staying warm, and breathing on their own.
Babies born at 32 weeks will generally not yet be strong enough to breastfeed because their sucking muscles are still weak and uncoordinated. They’ll likely need to be tube-fed for a few weeks.
That said, receiving breast milk is especially important for preterm babies. Compared to preterm babies who receive formula, those who receive human milk typically have higher survival rates, shorter NICU stays, and fewer serious health complications.
Even if you weren’t planning to breastfeed, you may consider expressing milk to help nourish your premature baby. You may also consider donor milk.
Most babies born at 32 weeks don’t have breathing problems, but your doctors and nurses will make sure they’re breathing properly.
Before your baby can safely go home with you, your doctor will make sure they don’t have any other health problems and are growing and developing enough to do well without NICU care.
Before they’re discharged, your baby will be evaluated on their:
- weight gain
- ability to suck and swallow milk on their own
- temperature regulation
- eye development and sensitivity
Babies born at 32 weeks might have some temporary health problems such as:
- low birth weight
- jaundice
- hypothermia
- feeding difficulties
Some long-term issues in babies born at 32 weeks might show up months to years later. These are not common, but can include slower development. In most cases, babies with learning or developmental delays catch up later in childhood with a little bit of extra help.
A 2017 medical study in France that followed 5,170 babies who were born between 22 to 34 weeks of pregnancy found that babies born at 32 to 34 weeks had very low risks of long-term health problems.
The researchers found that about 1 percent of babies born at 32 to 34 weeks had the neuromotor disorder cerebral palsy.
The same study tested 2,506 2-year-olds who were born prematurely. In the group born at 32 to 34 weeks of pregnancy, 36.2 percent scored slightly lower than average on a questionnaire that was used to test brain development.
While this means that some babies born at 32 weeks may have delayed learning development and skills in early childhood, and early intervention can have a significant impact in improving skills.
If your baby is born at 32 weeks, they have very good chances of being born healthy and developing just fine.
They’ll be considered premature, specifically moderately preterm, and will need extra medical care to make sure they’re healthy and growing normally before they can go home. Your baby may be in the hospital or NICU for several days to weeks.
In rare cases, a baby born at 32 weeks may have neurodevelopmental (brain and learning) delays. In most cases, they’ll catch up with some extra help during early childhood.
32 weeks of pregnancy what happens to the fetus
Contents
Signs that the baby will be born soon are already obvious at the 32nd week of pregnancy. At this time, the child takes the position for childbirth, usually head down, but there are other presentations. Mom and baby have most of the journey before birth behind them. A woman during this period feels how strong the connection she has with the baby.
Development and growth of a child
Almost all systems and organs are formed, the further task of a small organism is to grow stronger and continue to grow. At the 32nd week of pregnancy, the fetus weighs 1600 - 1900 g, and its length reaches about 40 - 45 cm. If the mother is expecting twins, their height will be slightly less - about 35 - 38 cm, and the weight is less than one and a half kg for each fetus.
Interesting! The size of each newborn is individual. Their height and weight depend on several factors: the parameters of the parents, the nutrition and diet of the mother throughout the pregnancy.
At this time, the fetus already becomes a real little man, with proportional body parts and facial features. He even has chubby cheeks. The skin brightens, becomes elastic, the number of folds and wrinkles decreases. There are other changes in the development of the baby:
- Since the fatty layer is formed and protects the fetus well, there is no need for vellus hairs, they fall out.
- The volume of the brain is 75% of the brain of an adult. But the size of the head still predominates in relation to the whole body. The child's brain continues to develop. And thanks to its parameters, the baby can move to the position of the head to exit the uterus, preparing for birth.
- The most active work on the 32nd week of the immune system. It produces antibodies that will serve as a reliable protection for a small person immediately after his birth. nine0018
- The bones of the whole body are strengthened, but the bones of the skull are more plastic, as the child has a difficult road through the birth canal.
- The kidneys and liver function at full capacity and are able to remove harmful elements from the body.
The child not only hears the sounds and feels the mother's mood, but also analyzes what is happening, expressing his opinion in jerks. He becomes cramped in such a previously cozy space, so the movements become more tangible for mom. Within an hour, the fetus changes its position about 5-6 times. nine0003
Important! If the baby does not turn head down, the doctor will definitely see this on an ultrasound scan and give recommendations. Special exercises that a woman must perform daily will help the child to take the correct position, the most optimal for childbirth.
Feelings and well-being of the mother
The figure of a woman by the 32nd week of pregnancy changes greatly. The protruding belly presses on the diaphragm, so the mother experiences back pain, she often has heartburn and shortness of breath. By this time, a woman can gain about 10 kg, but weight gain depends on BMI. nine0003
Important! Keeping track of weight and controlling kilograms is a must. A woman should gain no more than 500 g per week. Therefore, her diet should include all the foods necessary for the growth of the child and her body, but nothing more.
Many mothers suffer from swelling, fatigue and heavy legs. Varicose veins are also not uncommon during this period. It is necessary to control the drinking regime. Special elastic stockings will help to cope with the problem. During the day, a woman should rest with her feet on a raised platform. nine0003
There is such a thing as “training bouts”. The stomach at this time becomes stony, and the uterus is in good shape. This phenomenon is short-lived, you should not be afraid of it. Thus, the mother's body prepares for future childbirth. But if there are severe prolonged pain, spasms and / or amniotic fluid comes out, you should immediately call an ambulance. This means that the birth process began ahead of time.
Baby's pushes become more active and sensitive. If the mother is calm, then the child does not disturb her much. When a woman is irritable and nervous, the child feels it and reacts to her mood. nine0003
Tests and examinations
Planned ultrasound, the third in a row, falls exactly on the 32nd week of pregnancy. During this period, visits to the doctor should be at least once every 2 weeks. Doctor's examination includes the following actions:
- Determining the baby's heartbeat, its weight;
- Measurement of blood pressure and body weight of the mother;
- Determination of uterine tone;
- Measurement of the volume of the abdomen of a woman;
Using ultrasound, the doctor finds out in what position the child is. Using special formulas, he finds out the circumference of the head, abdomen and chest of the baby, the length of the hips. On ultrasound diagnostics, the doctor determines the correct development of the fetus and states the absence of genetic abnormalities. Also, the doctor will find out if the amount of amniotic fluid, the tone of the uterus and the degree of maturation of the placenta are normal. nine0003
Important! In case of any deviations from the norm, the woman will be offered hospitalization. In order not to risk your health and your baby, the doctor's recommendations must be followed thoroughly.
Premature birth - Juno
Premature birth: content of the article
What is preterm birth
The birth of a baby weighing more than 0.5 kg from 22 to 37 weeks is considered early. According to statistics, 15 million babies are born prematurely around the world. nine0003
In our country, until 2012, babies were registered who were born at 28 weeks, and all those born earlier - a week later. The development of obstetrics made it possible to nurse critically premature babies and increased their survival statistics.
Who is at risk
Any pregnant woman can give birth prematurely. Some expectant mothers have a higher chance of preterm birth. The risk zone includes pregnant women:
- under 17 and over 35; nine0018
- have more than one fetus;
- have structural features of the uterus or its cervix;
- use harmful substances - drugs, alcohol, smoke;
- have heavy physical activity;
- have a history of preterm birth;
- work in hazardous production;
- are subjected to sexual, emotional abuse, stress, mental stress.
At risk are expectant mothers who are not registered during the gestation period or ignore ultrasound, screenings, laboratory tests. nine0003
The threat of early preterm birth is more common with diagnoses: diabetes mellitus, anemia, hypertension, genitourinary infections, hypothyroidism, problems with weight before conception (deficiency or obesity), thrombophilia, vaginal bleeding. There is also a risk when conceiving through IVF, with congenital malformations of the fetus.
If a woman has previously given birth to a child ahead of schedule, the chances of premature birth remain in subsequent pregnancies. The same applies to the weight of the crumbs: if the firstborn was born with a lack of body weight, then his brother or sister may be underweight. nine0003
Risk factors
Doctors point to a number of factors that take place long before the conception of a child. These include:
- Gynecological diseases suffered in childhood or adolescence;
- Early initiation of intimate life;
- Hereditary factor;
- Pathologies of previous pregnancy: preeclampsia, fetoplacental insufficiency, premature birth;
- Excessive uterine distension in multiple pregnancies, polyhydramnios; nine0018
- Threat of early miscarriage.
Another risk factor is surgery or trauma to the abdominal organs during the gestation period.
Risk of preterm birth at different terms
The birth of a child prematurely has many negative consequences for him. It depends on the trimester in which the pregnancy ended.
The most severe consequence is the death of the infant. With early preterm birth in the period of 22-24 weeks, the threat is the highest - up to 80% of babies die. This occurs against the background of intracranial hemorrhage of 3-4 degrees, cardiopulmonary insufficiency, intrauterine infection of the fetus. nine0003
Among those born in the period of 25 - 26 weeks, 40% of babies die, in 27 - 28 - about 20%, in 29 - 32 - no more than 10%, and in 33 - 34 - 2% of newborns are at risk.
Modern medicine is able to provide care for a premature baby and save his life. But no one can guarantee a full healthy life. Such a child can subsequently be given disappointing diagnoses: cerebral palsy, mental retardation, retinopathy of prematurity. He may suffer all his life from problems with the digestive and respiratory systems, impaired vision, hearing, delayed mental and physical development. Diagnosis implies disability. nine0003
For a woman in labor, preterm labor is usually not dangerous. Without concomitant pathologies, the mother's body does not care how long the child is born. There are only psychological problems: stress, fear and worries about the baby. It is better for a mother to tune in that her child, in case of severe prematurity, will be taken to the intensive care unit for nursing, so she will not see him immediately.
A newly minted mother needs rehabilitation. Therapy is prescribed, depending on the cause of the pathology: a complex of vitamins, antioxidants, hormones. nine0003
Why preterm birth is dangerous
Infants are immature: their body is covered with a large amount of cheese-like lubricant, there is a deficiency of subcutaneous fatty tissue, few hairs on the head and fluff on the body, cartilage on the ears and nose are soft, the nails do not go beyond the fingertips, the navel is located closer to the pubis.
Babies are underweight. Depending on the weight of the crumbs, 4 degrees of prematurity are distinguished: at the 1st degree, the baby weighs from 2500 to 2001 g, the 2nd - from 2000 to 1500 g, the 3rd - from 1500 to 1001 g, the 4th - 1000 g and below . nine0003
The development of the genital organs has not been completed: the testicles in boys are not lowered into the scrotum, and in girls the large labia do not cover the small and clitoris.
Children have immature lungs. They cannot breathe adequately - often they need help. The cry is weak. There are also problems with digestion. The body cannot absorb all the components from mother's milk.
Extrauterine life for children becomes a strong stress. It's hard to deal with him. They poorly resist infections, quickly lose heat, thermoregulation is impaired. They are subject to hemorrhages against the background of fragile vessels. Especially dangerous are hemorrhages in the cervical spinal cord and ventricles of the brain. nine0003
Among the complications of preterm birth are intracranial hemorrhages, asphyxia, intrauterine growth retardation.
Types of preterm birth
Several classifications have been adopted. Let's consider them.
- By term: critically early - up to 28 weeks, significantly early - from 28 to 32 weeks, moderately early or late - from 32 to 37 weeks;
- By the mechanism of attack: induced and spontaneous. Induced cause artificially for medical reasons. Occurs in 40% of cases. Spontaneous in 60% of cases begin with contractions, in 40% - with a rupture of the membranes; nine0018
- By the nature of the course: spontaneous, with regular labor activity, without it and artificially provoked. In 80% of cases, preterm labor begins spontaneously. At the same time, the fetal bladder can be intact - and then the contractions are regular, growing. Or amniotic fluid may pour out, labor activity is chaotic. For medical reasons, early delivery can be artificially induced. For example, in case of danger to the life of the mother, intrauterine death of the fetus, or defects that are incompatible with life; nine0018
- According to symptoms: threatening, incipient and incipient. With threatening early premature birth, the lower abdomen and lower back hurt, the tone rises. Her neck remains unchanged, the external os is closed. When the process begins, pains appear in the lower abdomen. Regular contractions may begin. The neck is flattened or shortened. The main symptom of the onset of preterm labor is regular labor activity. The cervix opens by 2 - 3 cm, it happens quickly. nine0027
- Early activity of the fetal endocrine system;
- Infections and inflammatory processes - ureaplasmosis, mycoplasmosis, pyelonephritis, bacterial vaginosis. They stimulate the production of prostaglandins. Hormones affect the uterine muscles - cause contractions and premature birth; nine0018
- Placental bleeding. They occur with incorrect presentation or detachment. The situation is serious, there is a threat to the life of the mother. Therefore, with presentation, hospitalization is indicated;
- Neck weakness. In 20% of cases, it leads to preterm birth. This also includes such factors: the interval between the current and previous gestation is less than 2 years, the woman is expecting 4 children or more;
- Isthmic-cervical insufficiency. The cervix opens itself - a miscarriage or premature birth occurs. It is possible to open mechanically - when scraping after a miscarriage, IVF, abortion; nine0018
- Pathologies on the part of the baby - intrauterine infection, malformations of internal organs.
- Regularity of contractions;
- Neck changes - shortening and smoothing. informative method. For example, with a neck length of 3 cm, the risk of preterm birth in the next week is 1%. The patient is not admitted to the hospital, there is no danger to her and the fetus.
- Take care of yourself. Rest, avoid nervous overload. Sleep at least 7 hours;
- Eat well. Eat foods rich in vitamins, exclude fast food, fatty, fried, spicy and salty foods from the diet. Give up coffee and strong tea; nine0018
- Observe the drinking regimen. Try not to feel thirsty - drink water every 2 hours. If you don't want to - don't force yourself;
- Avoid physical activity. Active training, hard work, general cleaning alone are taboo for a pregnant woman. Try not to go outside on ice - you may fall, you will strain your muscles - this can increase your tone and provoke premature birth;
- Maintain personal hygiene. Wash your face after a bowel movement. Always wash and dry from front to back. This way you will not bring bacteria from the intestine into the vagina. Infections are provocateurs of premature birth; nine0018
- Lead a healthy lifestyle. Alcohol and cigarettes are taboo. Smoking pregnant women are predisposed to preterm labor. If you take medications on a regular basis, tell your gynecologist about it. Walk outdoors. Cancel active workouts in favor of leisurely walks in the park;
- Register at the antenatal clinic in the first trimester - at 6 ‒ 8 weeks. Visit a gynecologist, listen to him, take tests, undergo ultrasound, screenings;
- Be careful with sex. In the first trimester, it is better to limit or abstain from it as much as possible - the embryo must be fixed. With placenta previa and other pathologies, the gynecologist may forbid you to have intimate contacts - listen to him; nine0018
- Learn to understand your body. In the 2nd trimester, start listening to the baby: his movements, activity. Fix any changes, strange and unpleasant sensations - and talk about them to the doctor. In case of acute pain, contractions, spasms, blood, urgently call an ambulance - this may be a premature birth;
- Maintain bed rest. A gynecologist can advise you to rest. For example, with increased uterine contractions, tone;
- Rest every hour. Sit in a chair, lift your legs up. This will relax the muscles, eliminate swelling; nine0018
- Be aware of the signs of preterm labor. In case of their threat, you will not miss a moment and consult a doctor. Perhaps the process can be stopped with the help of drugs. Treatment minimizes complications in the premature baby.
In 40% of women in labor, water breaks, 35% gave birth quickly and quickly. The active phase lasts less than when the baby appears on time. The contractions are monotonous, long and painful, the pauses between them are small.
Causes of preterm birth
Doctors indicate the main causes of the pathology:
Chronic ailments, dental problems, angina, health status during gestation, genetic factors are all common reasons for early delivery. Sometimes it is impossible to determine. Although this is important for the development of effective means of preventing pathology.
Symptoms of preterm labor
We list the signs by which you may suspect that the baby is in a hurry to be born ahead of time. nine0003
Spasms over the pubis. They are similar to pain during menstruation.
Pain, pressure and discomfort in the genitals, thighs, pelvis. There is a dull pain in the lumbar region.
Feeling of pressure, pressure in the back.
Diarrhea, spasms and pain in the intestines.
Vaginal discharge - they get worse. May be watery, pink, brown, bloody.
Contractions of varying intensity. Touch your stomach with your fingertips - you will feel the contraction and relaxation of the uterus. Counted more than 4 contractions in 60 minutes? Call an ambulance - you need an urgent examination by an obstetrician. nine0003
The following symptoms are also dangerous: sudden blurred vision, flashes and “flies” before the eyes, incessant migraine, swelling of the face or hands, temperature of 38º C and above, painful urination, abdominal trauma, decreased fetal activity in the 3rd trimester (less than 10 movements in 12 hours).
Any of the above symptoms indicate the risk of preterm birth. Seek medical attention.
Diagnosis of preterm birth
Includes several stages.
Transvaginal ultrasound. The length of the cervix is measured, fetal fibronectin is determined - a kind of "biological glue" that binds the fetal sac to the uterine mucosa.
Gynecological examination. Allows you to assess the degree of opening of the neck, its length.
Rapid test for the determination of phosphorylated protein-1. The test determines the possibility of preterm birth. In the future, this helps prevent iatrogenic complications. nine0003
When diagnosing, 2 parameters are evaluated:
Differential diagnosis
Its goal is to correctly diagnose. The early birth of a baby is accompanied by cramps in the lower abdomen, diarrhea, pain in the lumbar region. These same symptoms are characteristic of other conditions: appendicitis, colitis, cystitis, pyelonephritis. nine0003
When complaining of pain in the lower abdomen, the patient is examined for the consistency of the scar after the previous cesarean section, for example. When the temperature rises, flu, sore throat, viral infection are excluded.
Diagnosis
Preterm birth is stated based on the clinical picture. Doctors are guided by such markers.
The first is the length of the neck - less than 2 - 2.5 cm.
The second is the determination of phosphorylated protein-1. nine0003
The third is the regularity of contractions. There should be at least 4 in 20 minutes.
Fourth - neck changes in dynamics.
Fifth - assessment of the degree of maturity of the neck. Determined by the level of PSIFR-1 in the cervical canal.
Usually the process begins rapidly, suddenly and intensely.
Treatment for preterm birth
The goal is to reduce the tone of the myometrium, reduce uterine contractions. This is achieved by blocking oxytocin receptors - it is the hormone oxytocin that triggers the birth process. nine0003
Such antagonists of oxytocin receptors are tocolytics. One of the modern representatives of this group of drugs is atosiban.
The remedy is effective, but has contraindications. It is forbidden to treat pregnant women for less than 24 and more than 33 weeks, with uterine bleeding, growth retardation, distress or fetal death, severe preeclampsia, with rupture of the fetal membrane after 30 weeks, placenta previa or its detachment. nine0003
5 stages of management of preterm labor
The first stage is forecasting their onset. Depends on the situation: the process is starting, has begun, or it is a threat.
Stage two - prevention of respiratory distress syndrome in a child. Doctors stimulate the maturation of the lungs. Apply funds from the group of glucocorticoids.
Stage three - prolongation of pregnancy. Doctors try to delay preterm labor by giving the baby's lungs and placenta time to mature. For this, tocolytics are used - they inhibit the contractile activity of the uterus. Usually prophylaxis is carried out - tocolysis is carried out before contractions. When started, therapy is ineffective. The duration of treatment is a maximum of 48 hours. nine0003
Stage four - preparation for the birth of a premature baby. The woman in labor is transferred to a higher-level hospital. The physiology of preterm labor does not differ from the birth of a child at term. But close attention is required from doctors to minimize complications for mom and baby.
The fifth stage is the prevention of infections and their complications. At risk are women in labor whose waters have broken. If the patient gives birth before 34 weeks, she can be pierced with a course of dexamethasone. It accelerates the maturation of the placenta and internal organs of the baby, reduces the risk of complications. nine0003
OB sequence
When registering a patient with preterm birth, the doctor gets acquainted with the exchange card, studies the general, gynecological and infectious anamnesis, and the results of examinations. Clarifies complaints and evaluates the condition of the woman in labor. He examines her, measures the pulse and respiration rate, temperature, pressure, abdominal circumference and the height of the uterus.
Clarifies data on the fetus: movements, measures heart rate by auscultation - listening to the heart through the mother's stomach through the device. To assess the condition of the crumbs, the doctor performs cardiotocography. The device records the heart rate. nine0003
Ultrasound is performed to assess the condition of the child and mother's organs.
A gynecological examination is carried out: with intact membranes - external, with their rupture - internal. This is necessary to determine the position and position of the child, to assess the degree of disclosure.
Conduct a laboratory examination. They take a smear from the vagina: culture for β-hemolytic streptococcus, bacteriological culture, take blood and urine for a general analysis.
According to the results of the examination, the obstetrician confirms or refutes preterm birth, their stage. nine0003
The expectant mother is informed about her condition, forecasts for the child. At the slightest opportunity, they try to prolong the pregnancy. If the child is ready to be born in the near future, the doctor determines the tactics of assistance, coordinates the issue of anesthesia with the woman in labor.
In the absence of indications for a caesarean section, they give birth naturally. This is the best way - it is less traumatic for the baby. A gentle approach is what a weak newborn needs. nine0003
Prematurity Care Policy
The woman in labor is provided with continuous psychological support. Describe the current obstetric situation.
With head presentation, they give birth naturally.
With pelvic - take into account clinical indications. Caesarean section is not the only effective method in this case. The operation does not improve the prognosis for a premature baby, but it puts an additional burden on the mother's body: it increases infection, morbidity, and complications. nine0003
With foot presentation, only a caesarean section is done.
Anesthesia is carefully selected. Avoid opiates - they depress the respiratory center, which is dangerous for premature babies.
At the birth of a baby before 34 weeks, vacuum aspiration is prohibited. It increases the risk of neonatal morbidity. Dosed episiotomy, exit forceps for the birth of the head and epidural anesthesia are performed.
The umbilical cord is clamped at least 1 minute after the baby is born. This tactic reduces the frequency of intraventricular hemorrhage in preterm pregnancies up to 37 weeks of gestation. nine0003
Control the state of the crumbs. CTG is done every hour for 40 minutes, auscultation - periodically.
General recommendations for prevention
You need to think about it from the first trimester. If you want to inform the baby, follow the advice of gynecologists.
Preterm birth prevention
It is divided into 2 stages: before conception and after.
Preventive measures before conception
It is advisable to carry them out to mothers from the risk zone. The gynecologist limits intrauterine manipulations, such as curettage. During IVF, the number of embryos for transfer is regulated taking into account the age of the expectant mother and her health. Inform about the possibility of premature birth at conception through reproductive technologies. nine0003
Hydration is shown - enhanced drinking regimen. It improves fetoplacental blood flow and reduces the risk of preterm birth.
Eliminate infections. It is advisable to do this at the planning stage, since antibiotic treatment during gestation harms the fetus.
It is recommended to postpone the conception of a child soon after the birth of an older brother or sister. Mommy's body needs to recover from the previous pregnancy. It takes him at least 2 years to do this. During this time, the uterus will return to its previous state, strength, vitamin reserves and body reserves will be restored. nine0003
Vitamin complexes are prescribed for predisposition to preterm birth for planning and expectant mothers. Protein-rich dietary supplements are helpful. They strengthen the immune system, improve blood circulation, protect the pregnant woman from infections - and hence the child.
Secondary prevention of early delivery
With the threat of premature birth, the condition of the pregnant woman is monitored at critical periods: from 2 to 12 and from 18 to 22 weeks. During these periods, it is better to stay in the hospital of the perinatal center. Doctors prescribe drugs to maintain and prolong pregnancy. nine0003
Therapy is selected on an individual basis.
With a short neck from 1 to 2.5 cm, progesterone suppositories are prescribed vaginally. The hormone is also shown in previous preterm births. This tactic reduces their risk by 35%. This is a natural hormone. It is efficient and safe. It is prescribed in the first trimester. Synthetic hormone is harmful: it can provoke gestational diabetes.
If there is a threat of early birth of the crumbs, sutures are placed on the neck.