What is Premature Birth ?
What is Premature Birth? Premature birth is a birth that occurs at three weeks or more before the normal birth time. Under normal conditions, birth will occur after 40 weeks of age. In other words, a birth is called premature if it occurs at 37 weeks of pregnancy or earlier.
The last weeks of pregnancy are the most important times for the growth of the fetus, especially the brain and lungs. Therefore, babies born prematurely tend to have more serious medical problems and should be hospitalized longer than normal-born babies.
Here are some facts about babies born prematurely:
- Babies born at the age of pregnancy have not reached 25 weeks have long-term disease risks, such as learning disabilities (learning difficulties), neurological disorders, and the worst is experiencing physical disability.
- The fetus born before pregnancy entering the 23rd week will not survive outside the mother’s womb.
- Almost all babies born at the age of gestation have not reached 28 weeks of interference with the pernap system
- If the baby is born after the 32nd week, the potential for long-term illness risk is quite low, not reaching 10%.
- If the baby is born after 37 weeks, the risk of their complications is smaller.
- Although the risk is small, the potential for the onset of complications persists.
Physically, premature babies look different from normal-born babies. Usually, they are small with a rather large head size. Body size and head look disproportionate. Other features in premature infants are:
- Less have the reflexes to suck and swallow, causing them to eat hard.
- Covered with fluff (lanugo) that grows bushy all over the body.
- His eyes were sharp. The shape of his eyes is not as normal as a normal baby because of lack of body fat.
- Respiratory disturbed and low body temperature at birth.
Based on data released World Health Organization (WHO) in 2012, more than 15 million babies in the world born prematurely every year. As many as 60 percent of cases occur in Africa and South Asia, including Indonesia. In fact, Indonesia occupies the fifth position in the list of 10 countries with the highest cases of preterm birth (675,700 cases). The average number of preterm births in Indonesia is also quite high, as many as 15.5 cases of every 100 births.
Causes and risk factors for preterm birth
Premature birth is caused by many factors. In most cases, premature birth occurs spontaneously, with no known cause. But there are some medical conditions that can cause premature births such as premature rupture of the membranes, pregnancy bleeding, hypertension during pregnancy, and weak or incompetent cervix.
The potential for premature birth in pregnant women may increase due to a number of factors. Here are some factors that increase the risk of preterm delivery:
- Often smoking both before and during pregnancy
- Lack of or overweight before pregnancy
- Preparation of an unfavorable pregnancy or lack of nutrition
- Health problems such as high blood pressure and diabetes
- Consume alcohol or use drugs during pregnancy
- Contain two twins, three, or multiples
- Pause a very short pregnancy from previous pregnancy
- Never give birth prematurely, miscarriage, or have an abortion
- Stress due to many thoughts
- Have problems with the uterus, cervix, or placenta
- Have an amniotic fluid infection or reproductive system
- Pregnancy through vitro fertilization (fertilization outside the womb)
Symptoms and complications of premature birth
The symptoms of premature birth can be felt by the mother. At first glance the symptoms look similar to ordinary pregnancy symptoms. To ascertain the difference in symptoms, patients are advised to consult your doctor immediately if you experience any of the following symptoms:
- Pain in the lower back
- Contraction every 10 minutes
- Cramps in the lower abdomen
- Exit the liquid from the vagina
- Bleeding in the vagina
- Often experience vaginal discharge
- Hip felt depressed
- Nausea, vomiting, or even diarrhea.
As mentioned before, premature infants have a greater risk of disease complications than normal babies. Based on the impact on the baby, the complications consist of two types, namely:
- Short-term complications. Premature babies are likely to experience a number of disorders of the body’s organs such as heart, brain, blood, as well as respiratory system disorders, digestive system, metabolic system, immune system, and difficulty controlling body temperature. Premature babies also have the potential to develop jaundice due to immature liver organ.
- Long-term complications. In some cases, premature infants have long-term complications such as brain paralysis (impaired motion, muscle shape, and posture), impaired cognitive skills, visual impairment, hearing loss, dental problems, psychological disturbances, to the most severe is infant mortality syndrome sudden.
Diagnosis of premature birth
In diagnosing preterm birth, most doctors will ask about the symptoms experienced by the patient and ask if the patient has a family with a history of premature pregnancy, as well as medications consumed during pregnancy. In addition, the doctor may also monitor the condition of the patient’s uterus to know the baby’s heartbeat and contraction of the patient.
If the patient has a potentially premature delivery, the doctor will advise the patient to undergo a number of follow-up examinations. The examination consists of:
- Transvaginal ultrasound, to detect changes in the cervix (cervix)
- Examination of the condition of the uterus, to monitor contractions of the uterus
- Examination to determine whether or not there is infection in the vagina
- Examination of fetal fibronectin, to determine the chemical reaction at the bottom of the uterus.
Prevention of premature birth
Before talking further about the handling of premature births, first know how to prevent it. During this time, the cause of preterm birth is often not known for certain. However, women may reduce the risk of preterm delivery by the following preventive measures:
- Live a healthy diet before becoming pregnant. Eating healthy foods rich in protein, fruits, and whole grains before pregnancy is effective enough to reduce the risk of premature birth.
- Increase calcium supplements. Taking calcium supplements of 1000 mg or more per day may reduce the risk of preterm delivery and preeclampsia (one of the complications of pregnancy).
- Take low-dose aspirin. To reduce the risk of preterm delivery, pregnant women are encouraged to take aspirin at a dose of 60-80 mg from the end of the first trimester of pregnancy. This method is used for pregnant women with a history of premature birth, preeclampsia, and pregnant women with high blood pressure.
- Using a parietal ring (cervical pessary). Pregnant women with short cervical measurements are advised to use a parietal ring to support the uterus in order not to descend. The shape of this tool resembles a ring that is placed in the cervix.
- Keep away from exposure to chemicals. Objects containing the chemicals referred to here are for example plastic, canned food, cosmetics, nail polish and hair spray (hair spray).
Treatment of Premature Birth
Treatment at preterm birth is divided into two, namely the handling before the baby is born and treatment after the baby is born. If the patient contracts earlier in childbirth, the doctor will administer the drug (usually a type of tocolytics) to stop the contractions and relieve the pain. Doctors will also give steroid injections to reduce the risk of complications in premature babies.
If this early treatment effort has been done but premature birth is inevitable, the doctor will provide special treatment for premature newborns in the neonatal intensive care unit of the hospital (NICU) for a certain period of time. Specific treatments include:
Put the baby into the incubator to keep warm. The incubator also helps the baby to keep his body temperature normal.
Installation of sensors in the baby’s body to monitor the respiratory system, heart rate, blood pressure, and baby’s temperature.
Giving fluid intake, nutrition, including breast milk through intravenous tubes inserted through the baby’s nose.
Babies born with yellowish skin condition will be given bilirubin light therapy to reduce the levels of bilirubin in the body.
Babies born prematurely often find it difficult to form their own red blood cells.
Blood transfusion may be done to increase the blood volume of the baby.
The doctor will check the condition of the baby’s heart through an echocardiogram examination using sound waves.
Ultrasound examination is done to examine the possibility of bleeding in the brain, as well as other organs such as liver and kidney.
The doctor will also check the baby’s eyes to check if there are abnormalities in the retina that can interfere with vision.