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Define Prematurity?
- Infant born prior to term,
- usually 37 weeks gestational age,
- postmenstrual age, or
- post conceptional age (PCA), or
- less than 259 days gestational age (WHO, 1997)
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Survival prognosis prior to 29 weeks based on___________?
gestational age
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Survival prognosis after 30 weeks based on ________ ?
weight
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LBW: Low Birth Weight = ___________ ?
<2500 gm
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VLBW: Very Low Birth Weight = _______ ?
<1500 gm
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ELBW: Extremely Low Birth Weight = _______ ?
<1000 gm
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SGA: Small for Gestational Age = ________ ?
2000 gm – 2500 gm
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What are the causes of prematurity?
- Spontaneous or idiopathic preterm labor(PTL) 45%
- Preterm rupture of membranes(PROM) 30%
- Medical complications necessitating delivery 25%
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What are the risk factors for prematurity?
- Age
- Ethnicity
- Socioeconomic Status
- Maternal Health Behaviors
- Previous Ob History
- Hypertension
- Hyperthyroidism
- Maternal Health Status
- Diabetesn Multiple Gestation
- Fibroidsn Polyhydramnios
- Stress
- Violent Relationships
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How can one prevent prematurity?
- Identification of Women at Risk
- “High Risk” Prenatal Care (S R = 18%)
- Decrease All Substance Abuse, including tobacc on Use of Tocolytics to Prolong Gestation
- Bed Rest
- Identification of Early Labor (PTL)
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What is the management of prematurity?
- Airway, Breathing & Circulation
- Temperature Control
- Immature Skin
- Feeding….Breast Feeding in NICUs
- Touch/Kangaroo Care
- Weight Gain
- Eyes (Protection & ROP)
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Issues of prematurity
- Historically, when weight = 5 5½ lb
- AAP Guidelines:
- 1) Sustained Pattern of Weight Gainn
- 2) Physiologic Stability (suckle, feed,temp)
- 3) Active Program of Parental Involvement(two caregivers)
- 4) Frequent Outpatient FollowUpn
- 5) Organized Program of Tracking and Surveillance
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