Premature

Premature's disease overview

What is

premature birth?

According to the World Health Organization, premature birth is an early labor from week 22 to the 37th week of pregnancy from the first day of the last menstrual period.

Premature birth: gestational age from 34 - <36 weeks

Medium premature birth: 32 - <34 weeks

Very premature birth: gestational age from 28 - <32 weeks

Extreme birth: gestational age <28 weeks

What will children have ?

Lightweight children.

Unpaid lungs so it is prone to respiratory failure and death. If children live, they still have a high risk of later respiratory diseases such as pneumonia, bronchitis ...

Children have not fully developed physically and mentally

Children are susceptible to congenital defects such as congenital heart, blindness, deaf, dumb ... Usually the burden of psychology and finance for parents.

Premature babies are still at risk of eye -catching eye

Therefore premature birth is one of the important issues for physicians and society.

Causes of Premature's disease

There are about 50% of premature births that do not identify the reason.

Here are some of the premature births :

Social factors

Low socio -economic life, not being fully cared for before birth.

Low weight of the mother and/or poor weight gain.

Labor hard during pregnancy.

Mother's age under 20 or younger children over 35 years old.

Mothers addicted to tobacco, alcohol or cocaine.

Occupation: Occupations in contact with toxic chemicals, heavy labor, stress.

The cause comes from the mother

Causes of systemic pathology:

Infections: Urinary tract infections, severe infections

Pregnancy injuries: Traumatic injury directly into the abdomen or indirectly due to abdominal surgery.

Heart disease, liver disease, body disease, anemia.

High blood disorders due to pregnancy: Pre -eclampsia - Production

Immune pathology: Phospholipid antibody syndrome

Cause:

congenital uterus: Two -horned uterus, one horn, double uterus, uterine partitions ...

Abnormal abnormalities in the uterus: uterine cavity, uterine fibroids, scars with scars.

Uterine open waist

Cervical surgical interventions such as the tip.

Causes come from pregnancy and appendages of pregnancy:

Pre -history premature birth - Risk of relapse 25 - 50 %. This risk increases if there are many premature births before.

Non -rupture, early rupture

Infections.

Multi -amniotic fluid: Early labor due to uterus too tight

multiple pregnancy: 10-20% premature birth.

striker, each other.

So to find the cause of premature birth , we must consider and re -evaluate the entire gynecological disease, there are causes on the side. Mother, on the side of the fetus, and the appendage of the fetus and have the causes of coordination.

Symptoms of Premature's disease

Occupation premature birth with the following symptoms and signs:

Abdominal pain: women feel abdominal pain or heavy abdominal pain.

vaginal discharge: may be vaginal mucus, bleeding or amniotic fluid.

Uterine mounds: Light, 1-2 uterine mounds in 10 minutes

Cervical may be long, closed but can also be deleted and open to <4cm.

Non -ruptured amniotic fluid: leading to labor in a short time.

premature birth with the following symptoms and signs:

Abdominal pain: Women with abdominal pain, increasing pain.

vaginal discharge: may be vaginal mucus, bleeding or amniotic fluid.

Uterine mounds: There are 2-3 uterine mounds in 10 minutes, increasing. The cervix removed over 80%, or opened over 2 cm, the amniotic fluid began to establish or early rupture.

People at risk for Premature's disease

Black women are at higher risk of premature birth than others. But any pregnant woman can be premature. In fact, many premature women while they have no risk factors.

Risk factors leading to premature birth such as:

Private history

Non -rupture, early rupture

Cervical problems have congenital problems (open waist, short cervical) or secondary (due to tip, cervical scraping) infection: urinary infection, vaginal infection, amniotic infection.

Uterine aneurysm too much: amniotic fluid, multiple pregnancy.

Uterine abnormalities: uterine fibroids, uterus with partitions, twin uterus

abnormalities of each other: young people, strikers

Smoking mother (related to young rupture), using stimulants, drugs

Poor nutrition, not enough weight during pregnancy

Overweight, obese during pregnancy

Make a history of miscarriage or abortion many times

In vitro fertilization

Having chronic diseases such as high blood pressure and diabetes

Trauma, psychological trauma

Prevention of Premature's disease

After identifying risk factors, the backup role is trying to eliminate risk factors:

Ensuring a balanced and complete diet

Gentle exercise, but it is necessary to avoid excessive exercise during pregnancy, especially for pregnant women with high risk

Do not travel far

No smoking or drinking alcohol

For pregnancy, there is a risk of premature birth and need to abstain from intercourse and stimulate the nipple because the uterine mound often appears after pleasure.

When signs of premature labor are available, it is necessary to go to medical facilities immediately for timely handling

When vaginal discharge needs to be examined and treated appropriately because this can be the cause of premature birth and early rupture.

Cervical ring stitching from week 12 to 14 if there is an open waist.

Diagnostic measures for Premature's disease

Besides being based on the medical history, a history of exploiting the above symptoms as well as vaginal examination to find signs of premature birth, the doctor will recommend some tests to determine the diagnosis. As assessing the status of the mother, pregnancy and the appendages of pregnancy:

Fetal fibronectin test (FFN): found in cervical secretions, vagina found in premature pregnant women. FFN acts as a biological adhesive that helps the fetal membrane stick to the uterus. When FFN (+) may be associated with an increase in the risk of preterm birth because it suggests that this adhesive has disintegrated ahead of time and alarming possible labor.

Measuring the length of the cervical canal: is considered as a prognosis and premature diagnosis. The vaginal ultrasound measuring the length of the cervical canal is an easy -to -do method. This test is most helpful when assessing high -risk pregnant women such as premature history, abnormalities in the cervix, cervical tip or have tips on the cervix

Quantitizing cervical epidemics

Monitoring obstetric: Allows monitoring and evaluation of frequency, length, intensity of uterine contractions and fetal hearts

Ultrasound of pregnancy: Assessing the fetal condition and the appendages of the fetus such as each other, umbilical cord, amniotic fluid

Some tests to find the cause and prognosis: blood formula, total blood biochemistry, liver enzyme ...

Premature's disease treatments

The attitude of handling for a different premature labor, depending on the amniotic fluid or broken, the gestational age is a very important factor. The purpose of the premature birth treatment is to delay labor if possible, until the fetus is adult enough.

General principles

Delaying labor for premature birth,

Maternity transfer to establishments capable of premature newborn care

specific treatment:

Absolute resting at beds, avoiding stimulation

A reduced drug - Cutting uterine contractions: The mounds are currently used in obstetric units such as: Magnesium sulfate, calcium channel blockers, beta - adrenergic drugs , Atosiban. The gestational age is the decisive factor for choosing to use medication.

Corticosteroid therapy: supporting lung adults with corticosteroids at the age of gestational 24 - 34 weeks. Use a dose of corticosteroids to increase fetal maturity and reduce the risk of cerebral hemorrhage, necrotic bowel inflammation.

Premature treatment when inhibiting labor failed

avoiding trauma for pregnancy: protecting the amniotic fluid until the cervix is opened, limiting history Use oxytocin, wide biometical cutting, cesarean section if indicated.

Anti -bacterial infection if early rupture, prevent vegetables, postpartum bleeding.

Ensure resuscitation, care for premature babies.

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