Prematurity
Premature (preterm) baby:
Birth before 37 completed weeks gestation. 8% of all births. Most problems seen in with infants born <32 completed weeks.
Birth before 37 completed weeks gestation. 8% of all births. Most problems seen in with infants born <32 completed weeks.
Predisposing factors:
-Idiopathic (40%).
-Previous preterm birth.
-Multiple pregnancy.
-Maternal illness, e.g. chorioamnionitis, polyhydramnios, pre-
eclampsia,
-diabetes mellitus.
-Premature rupture of membranes.
-Uterine malformation or cervical incompetence.
-Placental disease, e.g. dysfunction, antepartum haemorrhage.
-Poor maternal health or socio-economic status
-Previous preterm birth.
-Multiple pregnancy.
-Maternal illness, e.g. chorioamnionitis, polyhydramnios, pre-
eclampsia,
-diabetes mellitus.
-Premature rupture of membranes.
-Uterine malformation or cervical incompetence.
-Placental disease, e.g. dysfunction, antepartum haemorrhage.
-Poor maternal health or socio-economic status
Complications of prematurity:
Respiratory: surfactant deficiency causing respiratory distress
syndrome, apnoea of prematurity, chronic lung disease / bronchopulmonary dysplasia.
syndrome, apnoea of prematurity, chronic lung disease / bronchopulmonary dysplasia.
CNS: intraventricular haemorrhage, periventricular leucomalacia;
retinopathy of prematurity.
GIT: necrotizing enterocolitis ,inability to suck, and poor milk
tolerance.
Hypothermia.
Immuno-compromise resulting in recurrent infections.
Impaired fluid/electrolyte homeostasis skin water loss, poor renal function.
Patent ductus arteriosus.
Anaemia of prematurity.
Jaundice liver enzyme immaturity.
Birth trauma.
Perinatal hypoxia.
Later: increased risk of adverse neurodevelopmental outcome,
behavioural problems and sudden infant death syndrome (SIDS).
Signs of prematurity:
-Thin gelatinous skin and dark red in color.
-Poorly developed breast tissue, no palpable breast tissue or it is flat
and less than 1cm in diameter.
- The ear auricle is soft, no cartilage and there is slow or no recoil.
-soft auricle no cartilge slow recoil.
-Genitalia:-
male: the testes are not descended in the scrotum and no creases
on the scrotum.
on the scrotum.
Female: labia majora are not covering completely labia minora.
-Plantar creases are absent or only seen on the anterior 2/3 of the
sole:-
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