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Pregnancy and childbirth
Main article: Pregnancy and childbirth
Babies born before 21 weeks of gestation do not survive
The baby must be born as a result of a pregnancy lasting 40 weeks. If he was born before week 20 and weighs less than 500g, then he is considered premature. Such a newborn will not be able to survive.
For 2020, it is believed that if the baby lived 28 days, it means that he will survive. Very rarely there are cases of survival of children who are 21 weeks old.
Why a premature baby can't breathe oxygen or air
A premature baby cannot breathe normally, since his body is not able to contact air or pure oxygen. The lung tissue is not developed enough to provide oxygen to the whole body. Among other things, the lungs of the baby cannot be dealt with - they shrink.
This condition is called infant respiratory failure syndrome and is the leading cause of death in premature babies. The syndrome appears because the lungs of a premature baby are different from those of full-term newborns. The lungs of the latter are coated with a surfactant that keeps them in a expanded state.
This substance begins to be produced by the fetus itself, but only 1-2 months before birth. By 2021, over the previous 15 years, thanks to medical research, such a substance has learned to produce artificially.
The first analogue was created from a cow surfactant, the second from a human one. It is administered to an infant and administered at birth. Therefore, in modern times, doctors can save the lives of many more premature babies than in the past.
Oxygen therapy
Due to the "immaturity" of the lungs, many of the premature babies depend on medical oxygen for a long time. Long-term home oxygen therapy is a method of treatment using oxygen at a higher concentration than in ambient air, performed at home. In some children, oxygen therapy can last months and even years. The average duration of home oxygen therapy in children can be up to 12-15 months.
Chronicle
2023
The Moscow mayor's office reported 82% survival rate of premature babies in the city
The survival rate of children with extremely low weight (from 500 grams to 1 kg) in Moscow is 82%. Anastasia Rakova, deputy mayor of the capital for social development, announced this in mid-November 2023.
According to her, about 6 thousand premature babies are born annually in Moscow maternity hospitals, which corresponds to about 5% of the total number of babies born. The survival rate of children with a very low body weight (from 1 kg to 1.5 years) by 2023 reaches almost 99%, Rakova said.
By November 2023, there are five perinatal centers in Moscow, each of which is equipped with the necessary modern technologies to assist premature babies. In the near future, a new center will be opened in the capital at the hospital No. 31 named after Academician G. M. Savelyeva, according to the website of the mayor's office.
 | The most vulnerable and most alarming group of children is, of course, up to 26 weeks. Children who are born after 26 weeks, and even more so after 28 weeks, are certainly a group of children with a more prosperous prognosis for survival, for life. And this is due to the fact that we actively work with children at 22 weeks and 23. All the technologies that we find allow us to achieve colossal and quick results with other periods of gestation, including full-term children, - said the head physician of the Morozov hospital, neonatologist Valery Gorev, on the air of the Moscow Says radio station in November 2023. |  |
He noted that children who have criteria for live birth can actually be born alive and at 21 weeks. He will beat his heart, perhaps there will be some kind of motor activity, reflex reactions, but these are certainly children with whom it is difficult to hope for a positive result, the doctor added.[1]
Artificial placenta created for premature babies
At the end of June 2023, it is known that an artificial placenta was created in Spain for extremely premature babies. Animal tests confirmed the effectiveness of the development - it allowed the fetus to develop normally for 12 days.
The artificial placenta mimics the natural protective environment, Reuters reported. The solution is a translucent container of biocompatible material, inside which the lungs, intestines and brain of the fetus can develop. The device is connected to an amniotic fluid circulation system that isolates the fetus from external influences. At the same time, medical workers can carry out ultrasonic control and monitoring.
Babies born seven months pregnant or earlier are considered extremely premature. They have a high risk of death or disability. According to the World Health Organization, in 2019, about 900 thousand such babies died worldwide.
| | We created a system that allows the fetus to continue developing outside its mother - in about the same conditions as they were in the womb. The infant continues to breathe and receive nutrition through the umbilical cord surrounded by fluid at constant temperatures, said research leader Eduard Gratacos. | |
He leads a team of 35 specialists from BCNatal Medical Research Centre, an amalgamation of the obstetrics and neonatology departments of Barcelona's two hospitals, and Fundacion La Caixa, a charity funded by Caixabank. The first tests of the development were carried out on lambs. The next stage of the project will be testing the artificial placenta on piglets. In the future, the team intends to move on to adapting the device for human babies.[2]
2022: Smart nipple created to measure saliva composition in preterm babies
At the end of May 2022 at Washington State University, a team of specialists introduced a smart nipple that can provide continuous monitoring of electrolyte levels in saliva. The device can help avoid taking blood from premature babies two times. Read more here.
2021: Perm Polytech announced a diagnostic algorithm for detecting the pathology of the cardiovascular system in deep-eating children
On September 28, 2021, Perm Polytech announced a diagnostic algorithm for detecting the pathology of the cardiovascular system in deep-eating children. Read more here.
2020
84 thousand children in Russia were born ahead of schedule
According to Rosstat, in 2020, 84 thousand children in Russia were born ahead of schedule - before the end of the 36th week of pregnancy.
Survival rate of newborns weighing up to 1 kg in Moscow in 2 years increased by 18%
The survival rate of newborns with a body weight of 0.5 to 1 kg in Moscow in two years increased by 18%. This was reported on November 17, 2020 by the Moscow Department of Health (DZM).
According to the ministry, in institutions subordinate to him, an average of 400 to 450 children weighing less than a kilogram and about 750 children weighing from 1000 to 1500 grams are born every year. The increase in the survival rate of newborns with extremely low body weight in DZM was associated with the development of perinatal centers and a high level of obstetric and gynecological services in the capital of the Russian Federation.
By mid-November 2020, there are four perinatal centers in Moscow: S.S. Yudin City Clinical Hospital in the south of Moscow, M.P. Konchalovsky in Zelenograd, E.O. Mukhin in the east and City Clinical Hospital No. 24 in the north of the capital. It is also planned to open another largest perinatal center - at the hospital No. 67 named after L.A. Vorokhobov in the Western District.
For nursing children weighing from 0.5 kg in perinatal centers, special treatment methods are used. Cuvezes in intensive care and intensive care units are equipped with additional equipment that monitors the child's pulse, temperature and breathing, makes it possible to conduct blood tests and administer the necessary medicines. Water mattresses in them simulate the conditions of stay in amniotic fluid.
As added in the press service of the DMZ, in case of detection of certain pathologies, for example, manifestations of oxygen deficiency in a child or, if necessary, urgent resuscitation and intensive care, newborns together with mothers are transferred from the maternity hospital to children's multidisciplinary hospitals.
According to world statistics, every 10th pregnancy ends in premature birth, that is, babies are born at a gestation period of 22 to 36.6 weeks. In Russia, this figure is slightly lower and is 5-6%, the department said.[3]
2019
For 2019, doctors know how to save children born even at the 22nd week of pregnancy.
But still, the chances of surviving so early are low: only 3 to 22% of babies survive, and many of them have lifelong injuries.
Premature Babies Day
On November 17, International Day of Premature Babies is celebrated worldwide.
Notes
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