What problems may premature babies have in the future: the consequences of premature birth. Development and consequences of premature babies? Babies born at 28 weeks of gestation survive

28 weeks later ...)) Everything will be fine!

Don't worry, everything will be fine.

Everything will be fine! My friend gave birth to 600 gr. Just a little behind in development! And that's it!

Dastagul

A friend gave birth at 26 weeks, the child survived, now he is 8 months old, but naturally lags behind in development by 3 months

You know, I heard the opinion of doctors that it is easier to leave a 7-month-old baby than an 8-month-old ... I personally know a family who had a 6-month-old, already an adult, normal child.

They will survive, they will definitely be placed in an incubator for further development, they feed through the spout, everything will be fine, they are usually healthier than full-term ones, we have such a situation in the house, the child developed perfectly

Well, if you were born alive, then it's already good. now everything depends only on the child's organism and on the professionalism of the doctors. and what will happen next, now only time will tell.

My cousin sister was born 35 years ago weighing 800 grams, went out, graduated from school with a medal, the institute is already seven years old. Health, health and health again!

My nephew was born weighing a kilo and a height of 37 cm, grew up perfectly and now he got everyone with his "why"))) in the kindergarten one of the first in the group, a very capable kinder) everything will be fine with your friend, let her not worry)

Yeah! Mom now, probably, is not just worried, but does not find a place for herself ... She was lying with her daughter in the pathology of newborns, where it is mainly premature babies who are nursed, we, however, had pneumonia ... such babies lay ... I think that everyone went out! I hope that you live in a city where there are well-equipped hospitals, and there are certainly good doctors! The hardest thing is that the children are alone and the mothers have to sit at home without seeing the child - and this is very hard!

You need to be happy that you were born alive ... everything will be fine, my friend is lucky

Now they are nursing babies from 500 grams. But they may lag behind for a couple of months in development, there may be minor health problems. But in principle, everything is fine.

My relative gave birth to exactly the same baby, he was in the hospital for 3 months, now he is about 8 months old, a wonderful sociable boy. Lagging behind, of course, in development from their peers, but slowly catching up. It's okay for now. No one gives forecasts for the future, it remains to be hoped that everything will return to normal. And you need to believe and everything will be fine.

I watched the program. such children become absolutely normal by the age of 1.5 and catch up in the development of their peers

The kid will just be in the hospital, so to speak, to reach the required deadline ... do not worry, everything is fine !!!

I was born seven months old, though with a normal weight - 2700. Now 1.75cm and by the way never lagged behind in development, and my parents often told me on the contrary in my childhood - you are the most developed both physically and mentally, you turned your nose up))) by the way was an accelerator. And also .. I was placed in an incubator, tk. dropsy of the brain began, God had mercy on the disease, this disease has passed, since then I have fallen asleep badly, in childhood I could not sleep for 1-2-3 hours, and immunity in childhood was weak, frequent tonsillitis, and so fie-fie my health is a sin to complain. And I was born due to the fact that my mother slipped on the March ice and stretched out all over, apparently at that moment I wrapped myself with an umbilical cord and crawled out into the light on April 5 blue-blue) So hope for the best, the baby, though tiny, but hardy once survived.

Nobody will give you accurate forecasts now. The child will have a long treatment and nursing. It all depends on the degree of maturity of the lungs and the availability of modern equipment and drugs in the maternity hospital (hospital), as well as qualified doctors and nurses. Most likely, for some time the child will stay in the intensive care incubator, will be on artificial lung ventilation, then there will be a long period of treatment in the neonatal pathology department. Many of these survive, but develop in the future in different ways. There are also favorable results, but in any case, such children lag behind their peers in development and do not catch up with them soon. Children who survived 15-20-30 years ago cannot be compared. Then there was a healthier generation, and only a few children survived for such a period, but the result was not bad, because only the strongest survived (a kind of natural selection). Now they are trying to nurture everyone, another new breathing apparatus has appeared, medicines for expanding the lungs, but so far good results have been achieved only in large cities. And about the better survival rate of 7-month-old children is nothing more than a myth. The one who is more mature survives, and this directly depends on the term - more term, more chances. Well, of course, the course of pregnancy and the mother's illness must also be taken into account. And support your friend morally, you must always hope!

, perinatal yoga instructor, mom of six children: Welcome to the third trimester! If in the first third of pregnancy there was a laying of the main organs of the embryo, in the second - their "test tests" were carried out, then the last third of pregnancy is preparation for birth and subsequent life. Starting from the 28th week, doctors can leave a newborn: that is why, from this time, doctors no longer talk about abortion (if it happens, God forbid), but about premature birth. We, of course, will not rush things: there is still enough time before childbirth to prepare your body for the maximum.

To begin with, let's clarify the physiology of the generic process. In the first stage of childbirth, painful sensations (contractions) contribute to the opening of the cervix - this is a narrow "bottleneck" that connects the uterus and vagina. With each contraction, it opens slightly, and by the end of this period, the opening is 10 cm (usually the midwife or doctor determines it by touch during the examination). When the "path is clear", the baby's body can begin to move towards the exit, and this is the next stage of labor, when, after a short transition period from one stage to another, contractions change. At this moment, the woman in labor feels an irresistible desire to push, to squeeze the child out of herself. And, in principle, without any obstetric examination, this is irrefutable proof of the full disclosure and readiness of the cervix. Sometimes the midwife or doctor thinks that pushing is premature, because the cervix is ​​not open enough, and, pushing too hard, a woman can get swelling or rupture of the cervix. Then the doctors urge her to restrain the urge to push, waiting for full disclosure. However, in a normally proceeding, healthy childbirth, can anything at all be regarded as "premature" (or, on the contrary, "protracted")? Those who share the principle of naturalness argue: any childbirth proceeds as it should, and it is pointless to restrain attempts. It is only important that a woman is not prevented from being in contact with herself: if childbirth takes place without the influence of medications (stimulation with artificial oxytocin or anesthesia), then there is no reason not to trust the natural ancestral instincts. “Pain is a natural barrier against excessive pushing. On the contrary, if pushing correctly, it helps to rotate the baby and open the cervix, while relieving a huge part of the pain and speeding up labor by hours. Women feel tremendous strength when they manage to blend in with the contractions without fear, working together, because the pain is reduced and the time of labor is significantly shortened. ", - thinks so Lydie Owen, mother of six, American midwife who has delivered over 2,600 births.

How can you make labor easier without medication?
Deep breathing, relaxation and the ability to be in contact with your body will help both during contractions and during pushing.

How to survive contractions?
Every time you feel an approaching contraction, exhale deeply and try to relax all muscles as much as possible. This will make the fight more effective. Breathe it out in the way that you find intuitively for yourself, but when you feel that it ends, breathe it out again with a relaxed exhalation. This will help dissipate the inevitable tension that comes with pain. By being aware of your breathing, you can float in harmony with the waves of contractions instead of fighting them.

Expert's word
“In any birth, there are two important things: to relax as much as possible to create more space for the baby, and to relax all the muscles of the pelvis, especially the gluteal muscles, to help him come into the world. As for breathing, vocalizing exhalations at whatever tone feels pleasant at the moment will help the abdominal muscles work together with the contractions of the uterus in a push. The longer you can make one exhale, the further your baby will be able to move forward in one push. Try to keep the muscles of the face and all the other muscles of the body as relaxed as possible - in order to reduce the general tension (...) "Breathing" your baby into the world is an action filled with love, which is available to most women and is most favorable for mother and baby. "(excerpt from the book Françoise Friedman"Prenatal yoga for conception, pregnancy and childbirth").

How is it inside?
The third, last trimester of pregnancy has begun, which becomes for the child a period of growth and accumulation of strength for birth and extrauterine survival. His chest is already capable of breathing movements, the formation of the endocrine system continues, and his own metabolism is being honed. The skin loses its transparency - now it is wrinkled, reddish in color; the subcutaneous fat layer begins to develop.

Art by Mirta Groffman

Every woman dreams of giving birth to a healthy child in due time, unfortunately, not everyone succeeds. Every year there is a growing number of women who, for various reasons, cannot bring pregnancy to the due date.

Congenital pathology is rare, as a rule, the causes of the disease are unsuccessful abortions or injuries in previous births. What reasons can abruptly initiate premature birth? the timing of childbirth can be influenced by: - ​​severe stress - poor living conditions - insufficient nutrition - too much physical activity - if pregnancy occurs at too young or too old age - a sharp increase in body temperature

Pregnancy of some women is overshadowed by the threat of premature birth. 28 weeks is not enough time for the development of a healthy child - this does not add optimism to expectant mothers, but the problem should not be exaggerated either.

The risk of premature birth can be prevented.

You just do not need to forget about such a possibility of the development of events and keep everything under control during the entire period of pregnancy before childbirth.

First you need to know the answers to some frequently asked questions.

At what stage of pregnancy is childbirth considered premature?

Intensive resuscitation care can be provided with a weight of at least 500 g, and no earlier than 22 weeks of birth.

What is the frequency with which preterm labor occurs?

Premature births account for approximately 8%. The indicator differs for different countries and peoples. The reasons lie in the lifestyle and addiction of young people to smoking, alcohol and unhealthy lifestyles. This indicator is also influenced by the level of comfort in everyday life.

What reasons can cause premature birth?

Complications during pregnancy are one of the reasons.

Premature birth at 28 weeks can be caused by an incompetent cervix. The cervix cannot withstand the load necessary for successful bearing and fails at the most inopportune moment.

The next reason is genital infections. Infections lead to inflammation, as a result, the wall of the uterus becomes not elastic enough and loses the ability to gradually stretch as the fetus grows. In this case, pregnancy lasts only as long as the walls of the uterus are capable of stretching, and then the mother's body does everything possible to get rid of the pregnancy.

The causes of miscarriage can be rubella disease during pregnancy, hormonal disorders, pathology of the structure of the uterus. Insufficiency of the cervix, immune incompatibility of the father and mother of the child. Regular nervous stress.

Premature birth at 28 weeks of gestation can also be caused by multiple pregnancies, too large a fetus, and polyhydramnios. All these reasons lead to excessive stretching of the uterus, and the body decides to expel the fetus from the uterine cavity by any means available to it.

There are also congenital pathologies of the development of the uterus, which lead to premature birth due to the functional inability of the body to carry and give birth.

Detachment, adherence of the placenta, antiphospholipid syndrome may also be a prerequisite for premature birth.

Disorders in the work of the endocrine glands, diseases of internal organs and cardiovascular diseases, diseases

Another cause of premature birth is ischemic-cervical insufficiency (ICI). This disease is accompanied by the inability of the cervix to hold the fetus inside the uterus.

The strength of the muscle ring is simply not sufficient. The disease is congenital and acquired. Congenital pathology is rare, as a rule, the causes of the disease are unsuccessful abortions or injuries in previous births.

Which women are more likely to be at risk for premature birth at 22-27 weeks of gestation?

Early childbirth at 28 weeks is usually associated with cervical insufficiency and infections of the lower part of the fetal bladder, which leads to its rupture. This is more common with repeated pregnancy.

Who is at risk for preterm birth at 28 weeks?

This risk group includes about 30% of women giving birth for the first time. The causes of premature birth can be very diverse.

Is it always possible to prevent premature birth?

With the threat of premature birth and timely adoption of measures, labor in most cases can be suspended, but there is no way to stop labor that has already begun. You can only detain them to organize help for the mother and child.

Is premature birth dangerous for a woman?

Such childbirth is dangerous because of its suddenness and serious complications. As a rule, the hormonal balance in such women in labor is disturbed and their labor, as a rule, passes with more injuries than a delivery on time.

Is premature birth dangerous for a baby?

Premature birth is certainly very dangerous for a baby. A baby born at 28 weeks is still absolutely not ready for life outside the womb. Such children need to create conditions artificially. Colossal funds are spent on this. But it is not always possible to help. Children sometimes die

What should a woman do in case of a threat of miscarriage?

An urgent need to call an ambulance. Drink a sedative to lie down and calm down.

Which medical facility will provide the best care for premature birth?

Almost all obstetric care institutions in large cities are already ready to care for premature babies with varying degrees of prematurity. Babies born at 28 weeks, weighing 1000 g, have a chance to survive.

But it does not hurt to make inquiries where this is best done in your area. If there is a danger of premature birth, it is the mulberry that should be directed. The ambulance teams can help you with this, they know which clinic is better to go to for this or that pathology.

Is it possible to prevent premature birth?

In the arsenal of modern medicine, there are many methods to prevent termination of pregnancy at dangerous periods. It is important to seek help on time. The earlier treatment is started, the better the result will be and it is quite possible that premature birth can be avoided.

Treatment of women prone to premature birth, what is it?

As a rule, the cause of premature birth is the rupture of the fruit membranes of the fetus. This leads to infection of the mother and fetus. Moreover, the threat to the fetus is much higher. Therefore, in such cases, they prefer to wait and, if possible, fight the infection with medication without terminating the pregnancy.

Are you trying to stop preterm labor anyway?

If a woman's life is in jeopardy, it is necessary to specifically initiate a premature birth to save the mother and child.

Is pain relief possible if a woman had to give birth at 28 weeks?

Pain relief can be used, but in the case of spontaneous preterm labor, pain relief has many factors to consider. And think not only about anesthetizing the mother, but foresee the possible harm from the use of medications for a not quite full-term baby.

How can a woman who has had a preterm birth prepare for her next birth? It is advisable to go through the critical periods of repeated pregnancies in a hospital under the supervision of a doctor.

Does the postpartum period of a woman who has undergone premature birth differ from the postpartum period of a woman in the normal period of delivery? There are no big differences, but if the complications of the woman are left in the hospital for a longer period. If there are no complications, the delay in the hospital may be associated rather with the condition of the child.

In modern conditions, they have become more frequent due to the fact that there has been an increase in purely those pregnancies that were previously interrupted at an early stage due to various pathologies. Important factors for the threat of premature birth are both the health of the fetus itself and the condition of the tissues and organs surrounding it (placenta, water, shell). The mother's health, external unfavorable factors and many other conditions also play a significant role.

Today, up to 15% of children are born ahead of schedule, the figure has tripled over the past two decades.

What is the reason for the increase in the number of premature births and why are they dangerous?

What is premature birth: a medical definition

Premature birth or premature pregnancy is the completion of the gestation process with the birth of a baby in the period from the 22nd to the 36th week. An active labor activity is formed or medical intervention is performed for health reasons, which leads to the birth of premature babies requiring special care and medical interventions.

A particular problem on an international scale is the birth of children from 22 to 28 weeks of gestation, when the fetus is deeply and undeveloped. According to WHO criteria, if its weight reaches 500g and there are signs of live birth, it is nursed under special conditions, but the forecasts regarding the health and life of such a crumb are not very encouraging.

If the baby dies within seven days from birth, a similar situation is classified as late. In Russia today they are also guided by these conditions in relation to premature birth and are making every attempt to save the life of such a crumb.

Why does labor start early?

In each specific situation, the reasons that led to premature birth are their own, but highlight a whole group of provoking factors and immediate triggers that can lead to the birth of a premature baby. These are the influences that are formed in the complex system that connects the mother and the fetus, as well as affecting the placenta and umbilical cord, fetal membranes, waters and the uterus itself. Experts distinguish three large groups of influencing reasons:

• All factors and problems associated with the health and general condition of the mother herself;
• Any influences on the fetus that lead to the start of premature labor;
• Pathologies and problems associated with the placenta and fetal membranes, the amniotic complex.

Often, both problems associated with the maternal body and the health of the fetus, violations of the fetal-placental complex can be simultaneously detected, which complicates the situation and makes it difficult to prevent too early childbirth.

Maternal causes of premature birth

This includes a large number of influences associated with both the somatic health of a pregnant woman (work of internal organs, chronic diseases, infections) and reproductive (anomalies in the structure and functioning of the genital organs, hormonal disorders of the genital area, infections):

note

Foci of chronic infection of the whole body are no less dangerous than genital infections. Due to the allergization of the body and a decrease in immune defense, they can act as provocateurs of premature birth.

• Dangerous will be any chronic processes, starting with deep and ending with and. The spread of pathogens throughout the body threatens with infection of the membranes, violation of their integrity and labor induction against the background of infection of the fetus or without it.

Affect the onset of labor anatomical defects in the structure of the uterus and appendages. Anomalies in the structure of the organ, the presence, deformation and injury of the neck can become an obstacle to bearing the fetus before the due date. Sometimes the problem is underdevelopment (sexual infantilism), the presence of scars after operations or previous childbirth, tumors, adhesions as a result of inflammatory processes.

A common reason for early labor is insufficiency in the area of ​​the obturator muscles of the cervix(ICN). Weak or defective muscles cannot keep the growing fetus in the uterine cavity, the cervix gradually opens, which triggers childbirth at a fairly early date.

note

An important factor will be the health of the mother as a whole: severe, somatic pathologies, defects in the structure of internal organs violate the general condition of the mother. Under these conditions, pregnancy is perceived by the body as a threat to life, due to which the fetus can be rejected with the start of the birth mechanism. This is possible against the background, and kidney, in the presence of liver failure.

Causes of childbirth associated with the fetal-placental complex

Most often, premature birth can form due to severe damage to the fetus in the presence of chromosomal and genetic abnormalities, malformations of the nervous system and internal organs, severe infections or intrauterine death of the child.

Immunological conflicts in blood group or rhesus, problems with the work of the placenta during inflammation, calcifications, malformations, anomalies of attachment can lead to premature birth.

note

The placenta, as well as the maternal body, has a negative effect on the fetus. This is a special condition, which is provoked exclusively by gestation, and is characterized by progressive damage to organs and systems. The vascular tone, the work of the kidneys and the brain are especially affected. The result of gestosis is hypertension, edema and the appearance of protein in the urine, and the formation of preeclampsia, convulsive readiness, which threatens the life of the mother.

The formation of excess amniotic fluid (polyhydramnios), multiple pregnancies and abnormal fetal positions due to mechanical stretching of the walls of the uterus also threaten premature birth.

Social factors and external influences

A special group is made up of those factors that can lead to the start of premature birth in special categories of women. So, the social status of a woman is important, her attitude to pregnancy and exposure to stress, constant emotional or physical stress, support from the family and the child's father. More often, preterm birth occurs in difficult working conditions, living in unfavorable conditions, at a young age or in older mothers, in the presence of bad habits or occupational hazards, against the background of unwanted pregnancy, in mothers with many children, in the presence of previous abortions or premature births.

Premature birth up to 28 weeks

The most serious prognosis for the life and health of the child is formed by delivery in terms of less than 28 weeks..

The fetus at this time is still deeply premature, its organs and systems are still undeveloped, immature and incapable of performing their functions, because the baby has spent a little longer in the mother's womb.

Such babies are very low in weight, their survival rate at birth is not high, and those who are nursed by doctors in the conditions of incubators in the premature wards draw problems with the functioning of the nervous system, visual analyzer, kidneys and lungs. Nursing such a crumb is expensive, time-consuming and requires special equipment and the experience of doctors.

Most often, childbirth in this period is triggered as a result of ICI, intrauterine infection and rupture of membranes or injuries.

note

Such an early birth is dangerous not even because the fetus is low in weight, but because of the immaturity of its kidney tissue and lungs. For the full functioning of the respiratory organs, a surfactant is needed, a special lubricant inside the lungs, which does not allow them to subside on exhalation.

In children, it is formed much later, towards the end of the term. Such crumbs, born before the term, have hardware respiration, and the surfactant is administered to them in the form of drugs until they mature. The survival rate of children weighing from 500 to 1000 g is low, the prognosis for those born before 28 weeks of pregnancy is not very favorable.

Childbirth from 28 to 37 weeks of gestation

The birth of children in the period from the 28th to the 34th week of pregnancy with a body weight of 1000-2000g can be triggered by various factors. These are severe gestosis and infections, complications and ICI, many other factors.

Predictions for infants weighing more than 1000g are more favorable compared to the previous group of children... Although they have low body weight and are very immature, the internal organs work very weakly, but with adequate care and nursing, such children quickly gain weight, grow and develop well. The main thing for them is the maturation of the lungs and kidneys, so that they can breathe on their own and carry out metabolic processes. In order to ensure their full development, immediately after childbirth, they are transferred to the nursing unit for premature babies.

Childbirth in the period 34-37 weeks is usually provoked by diseases, lack of hormones, trauma and other factors.

Children are born with a weight of 2000 and more and are relatively mature, ready for an independent life... They are also nursed in conditions of premature separation, but they quickly grow stronger and can suck independently, absorb food and add weight. They are discharged relatively soon, usually when they reach a mass of 2500g.

Premature birth: stages of the course

According to the classification in obstetrics, three consecutive stages of preterm birth are distinguished:

• The onset of premature birth;
• Active struggles with pushing and the birth of a baby.

Such a division is necessary for doctors in order to determine the tactics of managing a pregnant woman and the amount of assistance, therapeutic and preventive measures. One or another stage is established according to the external examination, the state of the birth canal, ultrasound data, examination of the fetal bladder, uterine contractility and its cervix.

With crumbs with active therapeutic and protective measures, pregnancy can be extended until the due date, or the birth of a crumbs can be delayed in a more mature state.

The onset of labor is formed in the presence of cramping pains in the lumbar region and pubis, with the discharge of a mucous plug or discharge with blood from the genital fissure. There may also be an outpouring of amniotic fluid, the cervix is ​​shortened or its pharynx opens up to 2 fingers, signs of labor are formed.

Further, childbirth passes into a period of regular and active with intense pain in the uterus and perineum, gradual opening of the cervix and rupture of the membranes, insertion of the presenting part of the fetus into the pelvic cavity. Often, such childbirth proceeds with complications of varying severity - discoordination or weakness of contractions, loss of parts of the fetus or umbilical cord, bleeding.

Premature birth: mother's sensations

In terms of the mechanisms of the course, this type of childbirth can be very different from the birth of a baby on time due to the fact that labor starts against the background of complete unpreparedness of both the mother's body and the fetus. Such childbirth is characterized by a change in the rate of cervical opening, a reduction in the duration of the period of contractions, which can be shortened to 4 hours, while anomalies of the delivery act are frequent, they occur in 50% or more.

Often, such births proceed quickly or rapidly, they are painful with uneven and strong contractions, short pauses between them, the likelihood of injury to the birth canal of the mother and parts of the fetus sharply increases.

There may be a variant against the background of an initially violent labor activity, then with a decrease in the strength and frequency of contractions, their duration and strength, which leads to difficulties with cervical opening. In a state of discoordination of labor activity, medical intervention, the use of medications and benefits may be required. Immaturity and inelasticity of the birth canal is dangerous, because of which the risk of fetal hypoxia, its injury and death, and circulatory disorders of the brain increases.

What do doctors do to help the baby?

For a child, such childbirth is referred to as severe stress, and in the process he may suffer from hypoxia, especially against the background of problems with the placenta or if it is threatened. Such childbirth is carried out with constant monitoring of CTG and monitoring of the fetal heartbeat, prophylaxis is carried out through medications. In the process of childbirth, the heart rate changes greatly, and if the deviations are significantly pronounced, hormonal drugs are administered to the mother and the fetus to maintain adequate vital functions.

On attempts, the baby experiences severe stress and there is a high probability of neck and head injuries, brain with the formation of hemorrhages. For the purpose of their prevention, dissection of the perineum or special methods of labor management (the position of the mother on the side, which is opposite to the back of the baby), is applicable. This helps to facilitate its birth and protect the body and head from damage.

Alena Paretskaya, pediatrician, medical columnist