Prematurity

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Definition

A premature infant is one born before 37 weeks of gestation.

Main concerns

Essentially there are two bigs things that you need to worry about:

Other conditions

These are conditions with a higher incidence in premature babies but are less common than RDS:

  • Pneumothorax - more common in RDS. Treated by insertion of chest drain.
  • Apnoea, bradycardia and desaturation - all common. Usually treated by physical stimulation. Stimulants and CPAP can be used if more serious.
  • PDA
  • Infection
  • Brain inury - haemorrhages occur in 25% of preterm infants, usually with asphyxia or severe RDS.
  • Necrotising enterocolitis (NEC) - bacterial infection of ischaemic bowel. Abdomen is distend, stool sometimes contains fresh blood. Bowel distended on X-ray. Treat with parenteral nutrition and broad-spectrum antibiotics.
  • Retinopathy of prematurity (ROP) - basically, they get a retinopathy because the blood vessels to the retina are not fully blood vessels.
  • Bronchopulmonary dysplasia (BPD) - infants who still need O2 after the date of 36 weeks gestation. X-ray can be abnormal. Steroids, oxygen and sometimes CPAP can help.