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Extreme prematurity
- 1. Ainah Mahani Mahaiyuddin MBBS Stage 5
- 2. Today • Early problems of 25 weeks gestation baby • Review in out patient department at one (1) year age
- 3. Case study • FK, 12 months (CA: 8 months) old boy came for paediatric follow up • He is an extreme premature baby, born at 24 weeks gestational age, FK’s mother, 46 years old, with k/c/o HPT • Formula milk + breastfeeding (mother has not enough milk). Weaning at 6 months old • Birth history • 24 weeks into pregnancy • Mother’s blood pressure went very high and emergency lower segment caesarean section was arranged. • transverse lies, • After delivery • weight 795g • Child admitted to NICU for 4 months • Immunisation up to date • Development at one year of age • Gross Motor: sits straight without support • Fine Motor and Vision: transfers between hands • Speech and Language: uses finger to point at things. Peek-a-boo • Social / Personal: strangers anxiety
- 4. Early problems (Complication) Bone Marrow
- 5. 1 year follow up • Major goals • Examine the infant's motor, intellectual, and behavioural development • Provide an ongoing assessment of growth • Growth rates and Head growth • Evaluate the adequacy of nutrition • Proper feeding and weaning • Deliver preventive care • Immunisation • Follow-up on congenital disease • Check whether disease is worsening or any new complication arises • Referral to appropriate professional; eyes to ophthalmologist, • Adjust treatment to suit patient and ensure compliance
- 6. Summary • There are a lot of premature complications. • Try to prolong pregnancy until at term • Holistic approach and MDT is required
- 7. The end
Editor's Notes
- extremely preterm (<28 weeks) very preterm (28 to <32 weeks) moderate to late preterm (32 to <37 weeks).
- Corrected age • Low birth weight LBW <2,500 g • Very low birth weight VLBW <1,500 g • Extremely low birth weight ELBW <1,000 g
- Growth rates to determine growth failure which maybe due to nutritional deprivation caused by underlying disease eg. chronic lung disease, congenital heart disease extreme prem babies take 2 years to catch up to peer’s rate of growth or might never An assessment of head growth is especially important in patients with a history of a chromosomal disorder eg downs and brain insult secondary to hypoxic-ischemic encephalopathy