Women who are to become mothers are very sensitive to the timing, because much for the baby depends on whether the birth will be premature or urgent. How the baby is full-term depends on his condition, well-being and the peculiarities of caring for the baby after his birth.
Urgent delivery - what is it?
Pregnancy, according to medical reference books, lasts an average of 280 days. During this time, the baby manages from one cell to turn into a complex, multicellular organism, he gets the opportunity to feel, perceive, think. From 22 weeks of gestation, the fetus is considered viable, but this does not mean that he will necessarily be able to survive in the event of such an early birth.
The fact is that the child's body must prepare for the arrival in this world as best as possible.
The environment inside the mother's womb is strikingly different from that in which the baby will fall after birth, and the small organism must be prepared for serious stress.
After 34 weeks of pregnancy, tiny alveoli begin to produce a special substance in the baby's lung tissue - a surfactant. It, having accumulated in sufficient quantity, will allow the lungs to open up and provide free spontaneous breathing. If there is little surfactant, distress syndrome, acute respiratory failure, which is a common cause of disability and death of premature babies, may develop.
The weight of the child is also important. From the second trimester, a thin fetus begins to gain weight by increasing the mass of subcutaneous fat. Weight gain lasts until the end of pregnancy. This is important not only in order to delight mom and dad with a chubby booty and cheeks, but also so that the newborn can effectively retain the heat of his own body.
With malnutrition (low birth weight), the risk of systemic hypothermia of the child and his death is higher.
The weight and readiness of the lungs of the fetus are two of the most important criteria for a full-term baby. It happens that even with premature birth, children are born with a normal weight, and it happens that even with a timely birth, the weight is low. The readiness of the lung tissue may also be insufficient in a full-term baby, but more often this still happens with a premature baby.
So, what kind of toddler can be considered full-term? The answer is simple - born as a result of urgent labor. Urgent labor is a labor that occurs in the period from 38 weeks of pregnancy to 42 weeks of pregnancy inclusive. This means that on any day of this period, a full-term baby is born.
Childbirth from 22 to 27 obstetric weeks inclusive is considered premature. And the degree of prematurity is determined not by the gestational age, but by the weight and state of the child's respiratory system.
From 42 weeks of gestation, there is a need for induction of labor - if they do not start on their own, the woman is stimulated, since postmaturity is also not the best option for the baby (the placenta has aged, it does not cope well with protective and nourishing functions, the baby's head circumference is growing, which can complicate and complicate childbirth). After 42 weeks, one of the methods ("Mifepristone", mechanical methods) provoke the onset of labor.
For the period between 38 and 42 weeks of pregnancy (at full term), according to statistics, up to 80% of children are born. 15-17% of births are premature, about 3% remain for “late” births.
It is difficult to say when labor will begin, unless, of course, we are talking about a planned caesarean section. (operatively, on the recommendation of the Ministry of Health, you can give birth at any time according to indications, but usually - from 39 full weeks). In other cases (with or without a pessary, the first birth or the second - it does not matter), doctors prefer to wait for the onset of natural labor pains... It is through contractions that a woman's body notifies that it is ready for a complex physiological process.
Do not confuse urgent labor with fast or rapid labor. Rapid labor is a labor that proceeds too quickly, in violation of the duration of the periods, in connection with which it is considered a complication and can be dangerous for the woman in labor and the child. Urgent delivery is ideal, it is better not to think of it (the baby is full-term, the woman is ready).
Premature babies - features
Newborns are considered premature, according to the official standards of the WHO and the Ministry of Health of Russia, born before 37 obstetric weeks, with functional immaturity and weighing less than 2.5 kilograms. Height is also indicated - less than 45 cm, but in fact, height matters less than weight and functional maturity.
Premature babies, due to their gestational age (it is two weeks less than obstetric), look disproportionately folded, they have open cranial sutures and a small fontanel, they look thin due to a small amount of subcutaneous fat, the skin is red. Premature is characterized by underdevelopment of the genitals (with severe prematurity). Such babies either demonstrate a lack of reflexes after birth, or weak reflexes (sucking, grasping), they scream weakly or do not scream at all. Such children require special care and attention.
The reasons why childbirth can begin ahead of time, when the baby is clearly not yet ready for birth, are numerous:
- the age of the mother (before 19 years or after 40 years, the risk of preterm birth increases significantly);
- bad habits during pregnancy;
- poor nutrition of the expectant mother, lack of nutrition;
- severe stress in the expectant mother;
- past abortions;
- multiple pregnancy;
- gestosis;
- rhesus conflict;
- too short interval between data and previous births (less than 2 years);
- gynecological diseases of the expectant mother, anatomical defects of the uterus;
- chronic diseases in women (diabetes, diseases of the heart and blood vessels, kidneys);
- fetal malformations, intrauterine infection, pathology of the placenta.
Much depends on the degree of prematurity. The most favorable is considered the first - with her, the child at birth weighs from 2 to 2.5 kg, and childbirth occurs at a period of 35-37 weeks... The most alarming is the fourth. Children with her weigh less than a kilogram at birth, and this weight is considered extremely low.
Premature babies are not only low-weight crumbs with small stature. All organs and systems of the child are immature, the airways are narrow, the diaphragm is located high, breathing is shallow and weak, short-term stops (apnea) may occur, the lung tissue is immature, which increases the likelihood of distress syndrome, pneumonia. An immature heart beats dullly, and the vessels are so fragile that a variety of hemorrhages are not excluded (most often hemorrhage occurs in the brain). The stomach, kidneys, and liver are not fully ripe.
Grooming is critical. At the first stage, it is provided by neonatologists in the children's department of the maternity hospital, in intensive care. Then the doctors of the children's hospital take responsibility for the baby - most often they are not discharged from the hospital with premature babies from the maternity hospital, but transferred to the hospital of the children's hospital.
These babies need the correct temperature and humidity level, oxygen supply, and often tube feeding. If it is impossible to breathe on its own, the child is connected to a ventilator.
Babies with severe prematurity are placed in a special incubator, where exactly the optimal conditions for survival are created. Further predictions depend on how quickly the baby's condition will stabilize, how he will gain weight.
Children born with 1-2 degrees of prematurity are usually placed in special heated beds. The mother and baby are discharged when the child's condition is recognized as stable, and the weight "grows" to 2.5 kilograms.
Whether a premature baby will eat breast milk depends on his condition. In the absence of reflexes, the baby is fed through a tube inserted into the stomach. If there is a reflex, the baby can suck, then with a weight of less than 1.8 kg, they feed through the nipple, and babies heavier than 1800 grams can be attached to the breast. Premature babies are fed up to 10 times a day in small portions.
Vaccination (against hepatitis, tuberculosis, etc.) in the maternity hospital is not carried out for premature babies, it is done later.
Such babies should be shown to a pediatrician more often than full-term babies, and special attention should be paid to the prevention of rickets and infectious ailments - “early” babies have weak immunity.
Small full-term babies
Delivery on time is not at all a guarantee that the baby will be born with a weight that ideally corresponds to the tables and norms. The average body weight of a full-term newborn is from 2.5 kilograms to 4 kilograms. But sometimes small children are born on time. If a baby at birth at term weighs less than 2.5 kilograms, it is called underweight.
The reason for the appearance of a little toddler with a small weight on time may be intrauterine growth retardation - the baby received insufficient oxygen and nutrients. This can be caused by various abnormalities of the placenta, Rh-conflict and other signs of fetal dysfunction during the period of its intrauterine existence. In this case, there are usually some signs of physiological immaturity of a seemingly full-term baby. Care is provided according to the same principles as for premature babies.
A small child at birth can appear in women who have not eaten well during pregnancy, in women with liver and kidney diseases, as well as with gestosis, which is also called late toxicosis, and the amount of amniotic fluid that is different from normal (with oligohydramnios or polyhydramnios). The most favorable variant of the cause is a genetic predisposition.
If mom and dad are small in height and weight, there is a high probability that the baby's height and weight will also be small. But at the same time, there are no signs of trouble or immaturity of organs and systems.
Compared to premature babies, in low-birth-weight, full-term babies, everything is in order with reflexes, and therefore they can immediately be applied to the breast. Unlike a premature baby, born, for example, with a weight of 2 kilograms, a full-term low-birth-weight toddler with the same weight may not need resuscitation care, since he will breathe and eat himself.
The parameters of a child at birth are not at all a sentence. It is well known to doctors that both premature and full-term, but low-birth-weight babies, with adequate care, gain weight more intensively than their peers born with solid parameters. By 2-3 years, premature babies catch up with their peers completely. Small babies born on time are compared in development with others already by the year.
For children who were born with low birth weight, plays an important role breast-feeding. It is his adjustment, and not suffering over a lack of several hundred grams, that the newly-made mother needs to take care of. Even if the baby was born on time, but its weight is low, it is worth ensuring that the baby is warmed in the crib. Practice shows that in the first year of life, neurological disorders are possible - low-weight crumbs often regurgitate, worry more. Tempering is recommended for them, but only with the knowledge and consent of the pediatrician.
You can use the calculator to calculate height and weight norms specifically for your child. The calculator is based on standards from the World Health Organization (WHO).
And premature crumbs, and just very lightweight need the warmth of the mother's body, therefore, in the first month, doctors definitely recommend providing the baby close skin-to-skin contact - more often attach the baby to yourself. This is important not only from a physiological point of view, but also from a psychological one. Such contact allows the child to grow up in more complete conditions for normal mental development.
Low weight children, regardless of maturity, up to 3 years old are registered with a neurologist. Parents should not miss visits to the pediatrician, since it is very important to monitor the dynamics and pace of weight gain and height.
For more information on when a baby is considered full-term, see the next video.
