DISEASES OF CHILDHOOD : PREMATURE BABIES - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The definition of the concept. Premature babies - babies born before the normal termination date of pregnancy. In practice, to include premature children born prematurely, weighing less than 2 500 g and the growth of less than 45 see
Etiology. Illness of mother, injury, incorrect position of the fetus, twins.
Symptoms. Signs of prematurity: weight below 2,500 g and a height of less than 45 cm, chest circumference less than 30 cm, large head, short legs, poorly developed nails, excessive fluff, mild subcutaneous layer; in boys, the testicles have not descended into the scrotum, girls sex gaping slit; inability to regulate body temperature, susceptibility to lung atelectasis and pneumonia.
For. Somewhat delayed the development of physical, mental and static functions.
Premature babies tend at first to cerebral hemorrhage, atelectasis and pneumonia, after the first months of life to anemia, rickets; in a later age it is noted neuropathy, sometimes mental retardation. On the physical and psychical development of the child affected by the mode of life, nutrition, education and other factors external environment of the child.
Predicting the worse, the stronger prematurity and more pronounced than functional failure of some organs. To nonviable include premature infants weighing less than 1,000 grams and height less than 33 cm, chest circumference less than 21 cm and duration of fetal development less than 28 weeks. This is wrong. Survive and sometimes smaller children; the forecast is largely dependent on the care.
Antenatal care of the child, conducted through consultations for pregnant women.
The care of premature children.
1. Protection cooling and warmth (special infant incubators, warmers, warm room, and so on).
2. Proper nutrition: breast milk; the number of feedings: weighs up to 1000 grams - 11 - 16 feedings, with a weight of 1 000 - 1 500 g - 11 - 14 feedings, weight 1 500 - 2 000 g - 8 - 11 feedings and weight 2 000 - 2 500 g - 7 to 8 feedings per day; the amount of milk to increase gradually so that by the end of the first month to bring the coefficient of calories 130 calories per 1 kg of weight. Small and weak premature babies to the breast does not apply, and be fed with a spoon or pipette. From 2 to 3 months to enter vitamin juices, supplemented protein drugs or sugar syrup.
3. Prevention of rickets with 1½ - 2 months: the irradiation with ultraviolet rays and vitamin D; prevention of anaemia: at the age of 2 - 3 months - iron, hepatoxin, hemotherapy.
Preterm infants in the neonatal period are inclined:
1) to sclerodema (sclerödema) - the skin is red, thick, swollen; is easy when cooled;
2) to sclerema - sealing subcutaneous tissue without edema; this condition is prognostically very unfavorable; treatment: heat (infant incubators, warmers), caffeine, prolan (0.2 twice a day subcutaneously); infusion rangelovska solution under the skin; blood transfusion;
3) to afictions States (episodes of apnoea and cyanosis) due to cerebral hemorrhage, underdevelopment regulating the breathing centers of the medulla oblongata, congenital heart disease, flatulence; sepsis; treatment: oxygen inhalation; or hot mustard bath (caution), lobeline, tsititon;
4) to atelectasis of the lungs (auscultation and percussion often there is no objective data of the lungs; children persistently fall in weight, pale, cyanotic). Prediction is very serious.
Caffeine, lobelin, tsititon.