Childbirth at 29-31 weeks of gestation

At 29-30 weeks of pregnancy, most women usually go on maternity leave, and a real pregnant life without workdays is just beginning. But for some, pregnancy at this time is already ending with childbirth.

In this article, we will talk about whether childbirth at 29, 30 and 31 weeks of pregnancy is so scary and dangerous, what the consequences can be, and whether there are ways to prevent such childbirth.

A few words about the deadline

Until the end of the 90s of the last century, a child who was born up to 28 weeks inclusive, in general, was considered a late miscarriage, and the fact of his birth was registered only if the baby somehow miraculously managed to live for seven days.

Now the standards are different. From 22 weeks onwards, babies born are considered premature, but still children, and therefore they are obliged to provide all the necessary medical care.

Childbirth at 29-31 weeks of gestation is premature, early birth, which, of course, can be dangerous for both the mother and her baby. The share of early births at this time, according to statistics, accounts for about 15% of cases.

Children are born in a serious condition, but modern medicine can help them survive, although, alas, this is not always possible.

It should be noted that women after 29 weeks of pregnancy, childbirth in most cases begins spontaneous, spontaneous and only in 20% of cases, childbirth at this obstetric period has to be induced artificially for the available medical reasons. Almost half of women in labor leave amniotic fluid prematurely, and this is what becomes the beginning of labor. A little less often, the process of giving birth to a child begins with contractions.

Induction of labor or caesarean section at this time is carried out only for emergency indications, in which the life of the mother or child is in mortal danger if the pregnancy is prolonged.

Development and condition of babies, vitality

Childbirth at 30 weeks of gestation is undesirable, because the baby is in a state of active development, but if born, he has a better chance of surviving than children before 28 weeks of gestation. At this time, nine out of ten fetuses are located in the cephalic presentation, and this fact increases the chances of a successful outcome of premature birth..

The growth of babies at this time is on average about 40 centimeters, and their weight is about one and a half kilograms. But these parameters are very individual: there are children who, at 30 weeks, exceed the mark of one and a half kilograms, and there are those who do not reach the kilogram. The forecast of viability depends on the weight.

The skin of children born at 29-30 weeks and a week later is almost always red, because there is still little accumulation of subcutaneous fatty tissue. Basically, it forms in the last trimester, and this layer grows most actively in the last month of gestation. Meanwhile subcutaneous fat layer is equal to about 6% of the total weight of the fetus, and this gives reason to believe that the baby will definitely have problems with thermoregulation after birth. He will not be able to keep warm at first without medical help..

The auricles of babies are soft and stick out a little to the sides, the hardening of the cartilaginous tissue occurs later, and therefore the degree of softness of the ears will be an important diagnostic sign of the degree of prematurity at birth. Children at this time are often born with the remnants of thin, whitish hair on the body. Lanugo gradually falls out on its own and does not require treatment.

Children born at 30 weeks almost always have certain problems with the nervous system, since it is at this time that the processes of differentiation of the cerebral cortex should be completed. The basic reflexes are already there, but the respiratory reflex is still in its infancy.

The internal organs are formed and begin to function. Naturally, they are immature morphologically and functionally, but have every chance of fully functioning with proper care and medical attention.

The process of surfactant formation in the lung tissue is in full swing. This substance allows the newborn to breathe on its own. In a sufficient amount for this, surfactant accumulates in the alveoli by 38-39 weeks of gestation, childbirth at an earlier stage is a risky event for the very reason that the surfactant may not be enough. This is fraught with respiratory failure.

Those born at 30 weeks usually require mechanical ventilation.

Statistics say that survives among those born at 29-31 weeks of pregnancy up to 80% of children, if urgent resuscitation care is provided.

If childbirth takes place at home or in a medical facility that is not intended for resuscitation of newborns and premature babies, then only 5% of crumbs have a chance of surviving. According to the international classification of prematurity, such children belong to the third group, less often to the fourth. The third group is characterized by a serious condition of the baby at birth, but the forecasts for the future are more favorable. The fourth group includes children with extremely low birth weight (less than a kilogram). The likelihood of survival in this group is low.

Some more statistics. If childbirth occurs at 29-31 weeks of gestation, then:

in 70% of cases children survive, but have health problems that can be overcome at a very early age;
in 19% cases health problems in a child exist longer, but by the age of 10-12 they can be dealt with or minimized, they do not give disability;
in 6% of cases children survive, but remain disabled for life;
in 3% of cases children do not survive, die within the first week;
in 2% of cases stillbirth is recorded.

To a large extent, the forecasts will depend on how the intensive care unit is equipped. Such children need special resuscitation neonatal incubators, which maintain the required temperature, humidity, and oxygen supply. Feeding is carried out exclusively through a tube.

The task of doctors at this stage is bring the weight of the child to 1.7 kilograms, if at birth he was less... Then the child is placed in a special heated bed, in which he has to grow up to 2 kilograms. Then it will be possible to dismiss the mother with the baby home or transfer to the children's hospital for further treatment.

Causes

Childbirth at this time can occur for various reasons, knowing about which it is possible to prevent the premature birth of a baby. Most often, childbirth at 29-30 and 30-31 weeks occurs in women with a burdened obstetric history, several abortions in the past, operations on the uterus and ovaries. Also at risk are pregnant women who have had several miscarriages before, as well as premature births, especially if they occurred at the same time.

Various chronic diseases in a woman can also provoke premature labor., for example, kidney, heart, endocrine disorders. Women with genital infections, isthmic-cervical insufficiency, preeclampsia, diabetes mellitus can also give birth at this time. The reasons for the onset of labor at 30 weeks can be genetic abnormalities of the fetus, malformations, Rh-conflict.

Women who are under severe stress, who smoke and consume alcohol and drugs while carrying crumbs, and who are pregnant with twins or triplets, are also at risk.

Possible consequences

The risks for a woman during childbirth at this time are assessed as minimal. Ruptures of the genital tract and cervix are unlikely, because the child is small in weight and height, the diameter of his head is also small. The likelihood of postpartum complications is estimated slightly higher: the risks of inflammation and hypotension of the uterus are increased, in which it will shrink more slowly to normal size.

The main risks are children. Children with group 3-4 prematurity almost always have problems with neurology. In severe cases, if a child is born with a weight below a kilogram, there are high risks of total brain damage, cerebral hemorrhage, which can result in deaf-blindness, cerebral palsy.

Not a single doctor, even if he has the title of professor and rich experience in rescuing heavy and extremely difficult premature babies, can say in advance what the consequences of such an early birth may be. Everything will depend on the circumstances, complications and outcomes of the personal struggle of the crumbs for their own lives.

Neonatologists usually believe in higher powers more than other doctors. Because sometimes children who, according to all medical estimates, should not have survived in a completely inexplicable way, and children who had a good chance suddenly die for no apparent reason.

Much also depends on the parents. All the same neonatologists claim that the positive attitude of the mother, her belief in the strength and ability of her own baby to survive and be healthy, work miracles.

From a medical point of view, it is very difficult to explain this invisible connection between a mother and a premature baby, but even skeptical doctors of the “old formation” do not deny its existence.

Reviews of women

According to women, after childbirth at this time, problems often arise with the establishment of lactation. The baby is not brought in for feeding, he is in intensive care, and constant pumping is not always within the power of a woman tormented by fears and doubts. In a state of worries about the life and health of the baby, many women face a lack of breast milk.

There are entire communities on the Internet for parents whose children were born much earlier. In them, mothers provide each other with psychological support, and also share methods and advice on the rehabilitation of premature babies during the first year of life and later, because such babies need a qualitatively different care.