Preterm Births – A Common Phenomenon
Dr. Ranjit Chakraborti
Dr. Ranjit Chakraborti, a seasoned gynaecologist, sheds light on the intricate topic of prematurity in childbirth. Prematurity Defined: Dr. Chakraborti explains that prematurity refers to babies born with a gestational age of fewer than 37 weeks, calculated from the first day of the mother’s last menstrual period. This roughly translates to less than 259 days in the womb.
Challenges of Premature Births: Premature births come with a host of significant challenges. Dr. Chakraborti emphasizes the importance of understanding the causes and risk factors for successful prevention. He highlights that mothers with a history of previous abortions, twin pregnancies, or previous premature deliveries are at an increased risk for prematurity.
Rising Rates of Prematurity: Dr. Chakraborti draws attention to the increasing rate of prematurity over the past 15 years. Multiple births, often due to fertility enhancement treatments, have become a notable risk factor. Approximately one in nine babies, totaling about 436,000 a year, are born prematurely.
Impact on Baby’s Health: Dr. Chakraborti underscores that premature infants face vulnerabilities, particularly concerning the brain, heart, and lungs. These organs are more susceptible to delayed development or injury.
Long-term Effects: He mentions a study published in the New England Journal of Medicine that reveals severe disability among extremely premature babies. About half of those born at 25 weeks have severely delayed development by 30 months of age, with 10% experiencing severe neuromotor disability.
Recognizing Preterm Labor: Dr. Chakraborti advises vigilant monitoring for signs of preterm labor, including regular contractions, backache, pelvic pressure, and vaginal spotting. He also highlights potential causes of early labor, such as ruptured amniotic sac, infections, weak cervix, chronic diseases, uterine abnormalities, a previous premature delivery, substance abuse, and malnutrition.
Risk Factors for Preterm Labor: The doctor explains that certain medical conditions, like high blood pressure, diabetes, and kidney disease, can trigger preterm labor. He also notes that abnormal uterine shape and excess amniotic fluid can contribute to early labor.
Health Risks for Premature Babies: Premature infants face various health risks, including intracranial hemorrhage (bleeding in the brain), retinal problems, intestinal issues, necrotizing enterocolitis (a severe intestinal problem), and a higher risk of sudden infant death syndrome (SIDS). Dr. Chakraborti acknowledges that difficulties may emerge later in childhood for some preemies, such as underperforming in school.
Treatment for Preterm Babies: Depending on the stage of pregnancy and the progress of labor, treatment options vary. Bed rest and extra fluids may suffice to halt premature contractions. For women with a weak cervix, cervical cerclage, a surgical procedure, can help prevent preterm labor. Medications, including those blocking calcium channels in muscle cells, can stop contractions.
The Role of NICUs: For babies born prematurely, Neonatal Intensive Care Units (NICUs) are instrumental. Babies receive 24/7 intensive care from specialized doctors, nurses, and respiratory therapists. They are often placed in incubators to maintain body temperature, and sensors monitor vital signs. Some may need ventilators for breathing support.
Preventive Measures: Dr. Chakraborti emphasizes that maintaining a healthy lifestyle is crucial for preventing preterm labor. Seeking regular prenatal care, consuming a balanced diet, managing chronic conditions, reducing stress, following activity guidelines, and avoiding risky substances like smoking, alcohol, and recreational drugs are vital steps to ensure a healthier pregnancy.
Dr. Chakraborti’s insights help us grasp the complexities of preterm births and the importance of prevention and specialized care for these tiny, fragile lives.
