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Prematurity-An Overview

Prematurity-An Overview. Murila FV. Prematurity. GA < 259 days (37 weeks) 15 million every year worldwide More than 1 in 10 babies are born preterm • Over 1 million children die each year due to complications of preterm birth.

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Prematurity-An Overview

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  1. Prematurity-An Overview Murila FV

  2. Prematurity • GA < 259 days (37 weeks) • 15 million every year worldwide • More than 1 in 10 babies are born preterm • Over 1 million children die each year due to complications of preterm birth. • Rates of preterm birth are rising in almost all countries

  3. BIRTH WEIGHT Borderline LBW 2000-2499g Mild LBW 1500-1999g Very LBW 1000-1499g Extremely LBW <1000g PREMATURITY Borderline preterm 34-36wks Mildly Preterm 32-34 wks Very preterm 28-32 wks Extremely preterm <28wks CLASSIFICATIONS

  4. Causes of Under 5 Mortality in Kenya (WHO, Kenya Country Fact Sheet, 2006)

  5. Why are 4 million newborn dying in the world? Source: Lawn JE, Cousens SN, Zupan J Lancet 2005. based on cause specific mortality data and estimates for 192 countries

  6. Leading causes of mortality in NBU 2010

  7. RESPIRATORY DISTRESS SYNDROME Due to Immature Lungs Mx -O2 supplementation -Intravenous Fluids -Antibiotics CPAP Ventilator METABOLIC DERRANGEMENTS Hypoglycemia Acid base imbalances Electrolyte Abnormalities NEONATAL INFECTION Prevention-strict hand washing policy GIT NEC CARDIOVASCULAR ANOMALIES -Dehydration Monitoring and replacement -PDA of pre-maturity Prostaglandin inhibitors INTRA-VENTRICULAR BLEEDS -Stringent management of respiratory and cardiovascular complications ASPHYXIA -Effective resuscitation at birth Early Complications; Mx

  8. INTERMEDIATE Anaemiaof Pre-maturity Iron, folate and Vit A Rickets of Prematurity Vitamin D and Calcium Post-Haemorrhagic Hydrocephalus V-P shunting Retinopathy of prematurity laser therapy LATE Mental & physical development delay Rehabilitation Failure to thrive Nutritional support Increased morbidity and mortality Later Complications

  9. Late Complications • ADHD • Intellectual problems (arithmetics, solving problems, cognitive functions) • Short term memory • Coordination problems • Behavioral problems (shy, delinquency )

  10. Prevention of mortality • 50% of babies born at 32 weeks die • 75% of premature babies could be saved with feasible, cost-effective care , such as warmth, breastfeeding support, basic care for infections and breathing difficulties. • Further reductions are possible through intensive neonatal care.

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