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08 Mar '18

Critical Preterm Babies' Complications

Posted by Sandra Sosa

As you may see on the post: Common Preterm Babies' Complications, many of them are present on most of cases of preterm birth.

Such complications, even when serious, rarely had a catastrophic outcome and most of babies are able to overcome them; however those are not the only complications a preterm baby could face; in fact, there's a group of even more serious complications, some of them lethal, which could affect preterm babies.

One of the most frightening is intracranial hemorrhage. This could be to multiple factors, but almos invariable is associated with sever neurological impairment which could last lifelong. Treatment must be individualized according to each case, even when the prognosis tend to be ominous.

On the other hand there's also risk of bronchopulmonary dysplasia development, especially on very low weight babies requiring oxygen enriched atmosphere at the Neonatal Intensive Care Unit (NICU). 

On these cases, bronchopulmonary dysplasia is a consequence of oxygenCritical Preterm Babies Complications metabolites on alveoli, causing inflamation and scar which lead to impaired oxygen exchange and hypoxemia.

When Bronchopulmonary dysplasia occurs, patients may need oxygen therapy and respiratory support for long time, even after being discharged from NICU; fortunately, current knowledge about this condition as well the development of specific therapies such as surfactants help to a total recovery of almost all these children, who later will have a normal life.

Another problem to keep in mind is hypoglycemia; especially because on very small, low weighted babies, this condition might not give clinical signs until it's late.

Hypoglycemia is the consequence of many factors, being one of the most important the stress suffered because of living outside the womb; then even when properly feed and without any metabolic abnormality, just the fact of being living outside the womb before the right time produces enough stress to induce hypoglycemia.

Finally, around 7% of preterm born babies will develop a condition called necrotizing enterocolitis. When this occurs a part of the bowel dies.

The causes behind such complications are not totally known even when a combination of bowel poor blood supply and bacterial infections is the most accepted theory.

Necrotizing enterocolitis is a very serious complication with a mortality rate of 25%, so 1 of each 4 babies with necrotizing enterocolitis will die due to this complication. Of those who survive, surgery might be necessary during the first 4 weeks of life, especially if there's gut perforation.

Long term outcome is variable and sequels such as adherences and stricture are not uncommon; moreover, on those requiring surgery where long bowel portions must be removed, short bowel syndrome is a late consequence, leading to chronic complications such as nutritional issues as well growth impairment.

Fortunately critical complications are not so common and with available medical treatments, there's a hope for these babies; however even when a baby is discharged from NICU with the best possible outcome, there's still a risk of Late Preterm Birth Complications, as you may see by Clicking Here.


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