Everything you need to know about preterm birth

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Definition

What is a premature baby?

Premature babies are babies born long before the mother's time to give birth. This condition is also often called early labor or preterm labor.

Quoted from Pregnancy Birth & Baby, a normal time of birth usually takes place around 37-40 weeks of gestation. However, babies are said to be premature if they are born at less than 37 weeks' gestation.

The smaller your gestational age when you give birth to a baby, the more health complications that will occur to the baby.

This is because the fetus does not have enough time to grow and develop optimally so that it can adapt to the environment outside the womb.

Some of the health problems that premature babies can experience are that they may last a lifetime. For example, late development or intellectual disabilities such as how to communicate, difficulty learning, and others.

The following are the stages of premature birth based on gestational age:

• Late preterm, born between weeks 34 and 36.
• Moderate premature, born between 32 and 34 weeks.
• Very premature, born less than 32 weeks.
• Extreme premature, born at or before week 25.

Please note, from several cases. Most babies are born early in gestation weeks 34 to 36. In fact, the last weeks in the womb are classified as important enough for the baby's maximum development.

How common are premature babies?

The birth of premature babies is a fairly common complication of pregnancy. Many women who give birth prematurely have no clear trigger factor.

This complication can happen to anyone, but black women are more likely to experience it than other races. Not only mothers, babies born prematurely also occur in 60 percent of twins or more.

This condition can be treated by reducing risk factors. Talk to your doctor for more information.

Signs and symptoms

What are the signs and symptoms of giving birth to a premature baby?

There is a significant difference when looking at babies born prematurely with babies born at the right time. In addition, you can also see signs and symptoms from different sides, including:

The signs that a mother is about to give birth to a premature baby are generally:

• Contractions that occur every 10 minutes or more frequently and more than four times an hour.
• Stomach cramps.
• Discharge from the vagina, can be blood or amniotic fluid.
• The pelvis feels depressed.
• Lower back hurts.
• Symptoms that occur at gestational age below 37 weeks.
• Mild flu symptoms such as nausea, vomiting, diarrhea. It's best to call your doctor even if flu symptoms are mild. Especially when you can't tolerate fluids for more than 8 hours.

These symptoms can be confusing because some of them, such as pelvic pressure or low back pain, are common complaints during pregnancy.

In addition, the early contractions can be just Braxton Hicks contractions or false contractions. However, it is better to prevent than to be sorry. Contact your doctor immediately if you experience anything unusual during pregnancy so that premature birth can be prevented.

While the signs that can be seen from babies who are born earlier are:

• The size of the baby's body is small and disproportionate, the size of the head is bigger than the body.
• The baby's face is usually thin and looks sharp (not round) compared to the face of a baby who is born normally, due to the lack of fat stores.
• Her cry was not as loud as other normal babies.
• Thin hair (lanugo) covers many parts of the body.
• Low body temperature after birth, due to lack of body fat stores.
• Difficult breathing because the respiratory organs are not functioning optimally
• Lack of reflexes to suck and swallow, causing difficulty breastfeeding.

There may be other signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

Another thing to remember, babies born prematurely need extra care than babies born normally. Such as breathing assistance and other extra tools needed.

When should I see a doctor?

Correct prenatal diagnosis and care can slow or even stop the risk of early delivery of the baby, as well as other emergency medical problems.

So talk to your doctor right away to prevent this serious condition. However, if the baby is born prematurely, the doctor will immediately carry out various necessary treatments.

If you have signs or symptoms of prematurity or other questions, consult your doctor. However, when it is urgent, you can also consult and check for symptoms that are currently being experienced through Hellosehat.

Causes and triggers

What are the causes of premature birth?

There are various causes of babies born prematurely. Most cases occur as a result of spontaneous delivery. However, there are also those caused by medical and non-medical reasons, including:

1. Age at pregnancy

Women who are pregnant under the age of 16 and who are pregnant over the age of 35 have a 2-4% higher risk of having a premature baby than those who are pregnant in their 20-30s.

This risk exists because women who become pregnant at a very young or very old age have a higher risk of complications that affect premature births.

Therefore, more intensive care and maintenance of pregnancy is needed.

2. Infection during pregnancy

Inflammation in the body caused by infection can trigger the baby to be born prematurely.

Some types of infections during pregnancy that can trigger early labor are gonorrhea, chlamydia trachomatis, bacterial vaginosis, amniotic fluid infections, group B streptococcal infections (group B strep), and uterine infections.

Research shows that infections in the uterus are responsible for about 40% of preterm births.

Infections that occur in other parts of the body can also lead to premature birth, such as kidney infections, pneumonia, appendicitis, and urinary tract infections.

3. The mother's medical condition

Pregnancy complications such as gestational diabetes, preeclampsia, cervical incompetence to placental abruption can increase your risk of giving birth earlier than you should.

Likewise, if you have other medical conditions that can also be the cause of preterm birth. Some of the conditions include anemia, asthma, inflammation of the colon (IBS), kidney disease, lupus, or thyroid disorders from before pregnancy.

What increases the risk of having a premature baby?

Apart from the three main causes above, there are many other factors that can trigger women to give birth to babies born earlier than they should.

The following are the conditions most often risk factors for premature birth:

• Prolonged severe stress
• Pregnant body weight is not ideal (very thin or overweight)
• Pregnant with twins or more, more than 50% of twins are born earlier than single pregnancies.
• The distance between pregnancies is too close (only 6-9 months between the birth of one baby and the next)
• Have had premature birth before
• Smoking, alcohol, and drug use
• Too much amniotic fluid then breaks at less than 37 weeks of gestation
• Pregnant through IVF (IVF)
• Experiencing malnutrition during pregnancy
• Miscarriage or recurrent abortion
• Physical injury or trauma during pregnancy

Early labor is also sometimes triggered by the induction process that is too fast. According to the National Institute of Health, babies who are induced too soon at 37-38 weeks have a worse health condition than babies born at 39 weeks or later.

Often times the specific cause of preterm birth is unclear. Two thirds of preterm births occur for no reason. Therefore, there is nothing wrong with you doing a number of things to prevent premature babies.

Complications

What are the complications that can occur?

It has been explained a little above that babies born prematurely have health conditions that are more vulnerable than babies born normally. Quoted from the Mayo Clinic, another thing that can happen to premature babies is the occurrence of complications.

Although it is a rare case, here are some complications in premature babies that can occur, such as:

Short-term complications:

• Respiratory disorders.
• Heart defects.
• Problems in an area of ​​the brain such as bleeding.
• Difficulty controlling body temperature.
• Problems with the metabolic system as well as the immune system.

Long-term complications:

• Cerebral palsy or abnormal brain development.
• Impaired vision, freshness, and dentition.
• It may be difficult to learn something.
• Other chronic health problems.

Diagnosis and Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How do doctors diagnose preterm birth?

Your doctor can predict your risk during a routine pregnancy check-up, to see if the fetus is in an estimated condition or there is a risk of certain complications that you have.

If your doctor suspects you are at risk of giving birth earlier than the HPL date, he or she may undergo a physical exam and additional tests.

1. Check the content

The doctor or midwife will usually perform a pelvic exam to see the following conditions:

• The amniotic sac has ruptured
• Cervical thinning (efface)
• The cervix begins to open (widen)

2. Monitor breathing and heart rate

The doctor will continuously check the baby's respiratory system and heart rate. Blood pressure readings should also be taken frequently.

If there are abnormalities in the vital organs of the baby in the womb, premature delivery can be an option to save the baby.

3. Incoming and outgoing fluids

The doctor will monitor how much fluid the baby consumes through food and intravenous fluids and how much fluid is excreted through diapers, blood draws, and other tests.

4. Blood test

A blood sample can be analyzed to measure the number of red blood cells. Too little number of red blood cells can make pregnant women experience anemia, which is one of the causes of premature births.

5. Ultrasonic scan

Scan Ultrasounds can be done to check for bleeding or fluid buildup in the brain. In addition, this test can also check for problems with the stomach organs in the digestive tract, liver or kidneys of the mother who is diagnosed with preterm labor.

6.The fFn test (Fetal Fibronectin Test)

The fFN test is performed on women who show signs of preterm labor. Testing for fFN can help predict which pregnant women are showing signs of early labor.

This test is used to detect whether the fetal protein fibronectin is leaving the vagina of a pregnant woman.

To diagnose the occurrence of preterm labor, these secretions are usually found at the 22nd week of gestation, or about 5 months).

If fFN is detected during this time, it may be a sign that the woman may be at risk for preterm labor and delivery.

How to treat preterm labor?

If you are at high risk, your doctor will recommend an early, induction-induced delivery. After that, the management of preterm birth will focus on the safety of the mother and the baby.

1. Medical action

Handling that a specialist doctor gives to babies who are born early can be in the form of:

• Place the baby in an incubator to keep warm.
• Monitor the baby's vital signs.
• Inserting a feeding tube through a vein or through the nose into the stomach.
• Give intravenous fluids to babies.
• Provide light therapy, if your baby has jaundice (jaudince).
• Provide blood transfusions when needed.

2. Medicines

If there are no emergency conditions and early delivery can still be delayed, the doctor will consider several things.

One of them is the provision of drugs to prolong pregnancy and ripen the growth and development of fetal organs and systems, especially the heart, lungs, and blood circulation.

Depending on the baby's condition, treatment may include:

• Steroids.
• A surfactant liquid that is sprayed on the lungs to help them function more mature.
• Fine-mist (aerosol) or IV (intravenous) medication to strengthen the baby's breathing and heart rate.
• Antibiotic medication if there is infection or the risk of possible infection.

3. Other actions

When certain complications arise, sometimes surgery is needed to treat:

• Feeding problems, by placing an IV to deliver nutrients through the blood vessels.
• Necrotizing enterocolitis, by removing the damaged part of the premature baby's intestine.
• Retinopathy of prematurity, with laser surgery to mature blood vessels and minimize the risk of vision problems. The doctor can also give you an injection of medicine in the eye to stop the growth of new blood vessels in the eye.
• Prevent hydrocephalus getting worse by installing a so-called plastic tube shunt to remove excess fluid from the baby's brain.

Handling

What can I do at home to treat premature babies?

Here are some things you can do to treat and care for premature babies. Among others are:

1. Understand how to care for babies

Increase information and knowledge about how to care for and develop premature babies.

Recognize the signs of emergency that may occur in premature babies. Immediately consult a doctor if there is interference with premature babies.

2. Protect baby health

Premature babies are more prone to serious infections than other newborns of normal age.

Try to minimize bringing your baby to crowded places and make sure everyone who comes in contact with your baby ishes their hands first.

If you have any questions, consult your doctor for the best solution to your problem.