Premature babies

Dr. Gülnihal Şarman / Child and Neonatal Diseases Specialist

Babies born before 37 weeks are medically prescribed and require special care. I would like to inform you about this subject that I have gained many years of experience and share my suggestions.

The pregnancy process is calculated over 40 weeks in single pregnancy. If birth takes place before 37 weeks, this will count as preterm birth. But in multiple pregnancies; there is no definite pregnancy period determined especially in twins, triplets or quadruplets. As the number of babies increases, it becomes impossible for a pregnant woman to complete 40 weeks. If abnormal symptoms are seen between the 24th and 34th weeks of pregnancy, there is a risk of giving birth to the baby early. Unless the water bag bursts, doctors can take some precautions to prevent birth. Preterm birth can be postponed by giving drugs and serum to the expectant mother and following closely. However, it is impossible to prevent premature birth by 100%.

Why are some babies early?

While there may be some problems during pregnancy, it is possible to list the reasons as follows:

1 Carrying more than one baby: Pregnancy with twins, triplets or more babies

most of them result in preterm labor.

2 Pregnancy poisoning (Preeclampsia):

It is the cause of 15 percent of all preterm births. It is dangerous if symptoms develop quickly. If it progresses further, conditions such as loss of consciousness, unstoppable bleeding, and referral may occur. The only way to stop fast-moving pregnancy poisoning is to deliver the baby. This causes the baby to be taken early.

3 Early burst of water bag: In this case, the risk of preterm labor and infection is high. Decisions should be made based on the amount of fluid left in the uterus and the condition of the baby. Medications should be applied to delay delivery and mature the baby's lungs. If the symptom of infection begins, the baby is delivered.

4 Bleeding begins: Bleeding may begin as a result of placenta settling on the cervix. Sometimes, although the placenta is well placed, it suddenly leaves the uterus and bleeding begins.

5 Abortion or premature births in previous pregnancies.

6 Inability of the baby to grow in the womb: If blood circulation in the placenta is insufficient, the baby cannot grow enough in the womb.

7 Mom's smoking and drinking alcohol: In recent years, women of childbearing age seem to smoke more. Nicotine in cigarettes contracts placental vessels, prevents blood flow to the baby and prevents it from growing. A pregnant woman should definitely not smoke and drink alcohol. Support for quitting smoking can be obtained by calling Alo 171 of the Ministry of Health's Smoking Cessation Line.

8 Stressful events: serious fall, traffic accident, fire

Conditions that can create stress for days like ... There is no evidence that daily stresses occur in preterm birth.

9 Pre-existing diseases of the mother: such as heart failure, kidney failure, diabetes that needs insulin use…

10 Unknown reasons: Why can't be known in 1/3 of preterm births.

The symptoms may be very faint or not at all.

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Is It Possible To Prevent Premature Birth?

If the risk of preterm delivery is predicted, doctors may recommend bed rest. Especially in the case of multiple pregnancy, the probability of giving birth is high. To reduce the risk of preterm birth, the following are recommended:

• Working hours should be reduced or busy work tempo should be decreased.

• Stairs should not be climbed, shopping bags should be carried and housework should be reduced.

• Heavy work should be avoided (working in the field or garden, mowing grass etc.).

• Two-hour and two-hour rest intervals should be created a day.

When should I go to the hospital?

If any of the above symptoms are seen, it is necessary to consult a doctor and go to the hospital. Upon arrival, nurses and doctors will examine the expectant mother and tell her how close the birth is. They will perform some blood and urine tests by following the contractions. They will endeavor to prevent the baby from being born prematurely by evaluating the condition of the baby with ultrasound.

Intensive Care Process in Early Birth

After preterm birth, babies lie in intensive care for different reasons. Although the most common reason seems to be born prematurely, babies may enter intensive care for reasons such as non-feeding, surgical reasons, respiratory pauses. New Born Care units are units that are born too early, too small or timely, but specialize in caring for sick babies. It is important to reduce the volume and mobility in intensive care units. Reducing the sound of the environment can be difficult at busy times, but it is necessary to create a calm environment as much as possible. Research shows that sick babies are very easily stimulated. It is important for babies to recognize the sound and smell of their mother.

Psychology of Families

After preterm birth, mothers can feel "defeated" in many ways. He may want to take his baby and take him home. It may be in the form of a questioning that does not stop because of its premature birth. Premature parents always call these times “very difficult”. They cannot forget their support from their families and friends. They can spend the following weeks and months in anxiety and rush. Parents should identify those who can really help them. It may be good to share your worries and feelings with someone you never knew. El Bebek Gül Bebek Association in Turkey, volunteer mothers engages in project. According to this project, volunteer mothers who had a previous history in the neonatal unit support families who are in the same situation by telephone. You can refer to www.elbebekgulbebek.org. Sharing your feelings with other families will help mothers. It should not be forgotten that the health status of each baby is different. Even babies born in the same week exhibit different conditions. For this reason, they should not make comparisons when meeting other families and they should not ask their babies' health status and compare them with theirs.

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What should be the conditions for returning home?

Did it reach 1800-2000 grams?

Although it is no longer a strict rule, it is a good measure for comfortable home care. Babies who are very well developed in every way and do not need to stay in the hospital can go home when they are less than this weight. Sometimes babies over 2000 grams can still stay in the unit due to other problems

Is breathing regular?

Respiratory stops should not have existed for at least 3-4 days. 30-34 weeks old babies 35-36. reaching this maturity in weeks, their babies born very early 40-44. You may have to wait until weeks.

Can they do all their feeding with a breast or bottle? Can he take at least 15 grams a day?

If he / she is doing the searching, sucking and swallowing while breathing regularly; The baby is called feeding well. Babies are usually fed 7-8 times a day in the unit. This order is expected to continue at home.

Can it warm up in an open cradle without incubator?

A baby who can keep his heat apart from the incubator and gain weight is now easily cared for at home.

Baby Visit

There are some points that should be considered during the process of stopping babies in incubator.

• If there is a fever, cold and diarrhea condition, if there are any wounds and cold sores on the skin, a doctor should be consulted.

• Before going, a shower and clean clothes should be worn every day.

• Nails should be cut. Nail polish should not be applied.

• Accessories such as rings and bracelets should not be worn. They can both harm and carry germs when embracing the baby.

• When entering the intensive care unit, hands should be washed with a special soap up to the elbows. If you wash the hand with soap, foam it and hand should be washed for at least 1 minute.

• He can wear a visiting apron and go inside. (In some hospitals, it may be requested to wear a plastic bag on the shoes before entering.)

• It is quite normal for parents to feel excited before entering. A deep breath should be taken.

• Hands should be washed again after coughing, sneezing and after changing the diaper of the baby.

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