Premature girl meh. View full version. Cardiovascular system of premature babies

Baby Mara Washek was born at 10 weeks ahead of time with a weight of one and a half kilograms and big health problems. Mara spent six weeks in the ward intensive care and survived despite the initially unfavorable prognosis of doctors, Express reports.

The girl's father, Shane Washek, is a famous freediver in Scotland. He accompanies tourists who want to swim with sharks in the waters of the Atlantic off the coast of Scotland. And the name Mara in Gaelic means "sea." Therefore, it is not surprising that as soon as Mara was discharged home, dad began swimming with her. The baby loves water very much and is not afraid of it at all.

And recently, Mara had her first freediving lesson - she and her dad swam in the pool under water, and her mother, Nikki, captured this moment on camera. Both Mara and Shane seem to be perfectly happy. Shane decided to start training while Mara still had the natural reflex to hold her breath while submerged.

“After such a difficult start in this world, now Mara is doing well. She will soon be five months old and feels great in the water. Not ready for the Atlantic yet, but just right for the pool,” Shane explained. “She is our little mermaid. She had to go through a lot and win no matter what,” says Nikki.

Mila

Good day to all! Bored on the forum today, let's chat. Faced not by hearsay, but with the first BM with betrayals, I thought about why people cheat in marriage? What is missing, or the partner stopped liking, love is gone, or what makes people go for treason. For me, this is unacceptable, because I think that get divorced and live as you want and with whom you want at least hundreds of times a day. Why hurt, even if not a very beloved partner? What do you think drives people to do this? I asked BM why he did it, but he could not really answer me anything. I moaned and everything. The topic is chatty, nothing more. Great weekend to everyone!

Anonymous

I am writing to the forum because there is no one else to consult with.
I love my son very much, any communication with him is a pleasure and joy for me. He is an adult, and of course, we communicate little. And so I asked him and his girlfriend - let's go three of us to barbecue, to nature. It's just one day. Before that, they went on a long trip with friends, I didn’t see him for almost two months ... In general, we planned to go to barbecue this Sunday. But I see it's kind of sour. It turns out he doesn't want to. And in general, "all these are gray and dull everyday life," as he said.
I'm so sorry, I can't hold back my tears. I mean nothing to him to such an extent that it is impossible to go with me to nature once a year. Why am I? Only earn money and provide for the family?
I understand that most of the comments now will be in the style of "Samaduravinovata", but maybe someone will advise something sensible ... Otherwise, I don’t want to live at all.

Anonymous

And what name for the girl can you come up with for the patronymic Yaroslavovna? I have always liked Milan, but my husband does not like the combination with the patronymic at all, he says something shapeless, vague, jelly turns out. And how do you like it in general by ear and the complexity of pronunciation? The surname is Russian, ending in -eva, not the most common.

Circe

Several times I re-read the topic All professions are good and a picture presented itself to me. City N. City of forum children. In this city there are no professions that parents did not want for their children. What we have. There are no doctors in this city (maybe a couple in the morgue). Hospitals, polyclinics are empty, There are no staff in kindergartens and schools. Well, let's say, let's fantasize further, everyone has apartments (only who built these houses), no one eliminates the problems with electricity, because no one wants the child to be a working specialty. There are no sellers, cashiers, loaders in the stores. Yes, and there are apparently no goods. No police, no traffic police, no military, planes fly around this city, no janitors, cleaners. In general, the city is a fairy tale, a dream city. Brad of course, but such a picture emerges. How to survive in such a city, provided that you can not leave it. Moms and dads can only watch..

- these are children born before the due date, functionally immature, with a weight below 2500 g and a body length of less than 45 cm. Clinical signs of prematurity include a disproportionate physique, open sutures of the skull and a small fontanel, an unexpressed subcutaneous fat layer, hyperemia of the skin, underdevelopment of the genital organs, weakness or absence of reflexes, weak cry, intense and prolonged jaundice, etc. Nursing premature babies involves organizing special care - temperature regime, humidity, level of oxygenation, feeding, if necessary - intensive care.

General information

Premature children are those born between the 28th and 37th weeks of pregnancy, having a body weight of 1000-2500 g and a body length of 35-45 cm. The gestational age is considered the most stable criterion; anthropometric indicators, due to their significant variability, are conditional criteria for prematurity. Every year, 5-10% of children from total number newborns.

According to the WHO definition (1974), a fetus is considered viable with a gestational age of more than 22 weeks, a body weight of 500 g, a body length of 25 cm. a length of less than 35 cm is regarded as a late miscarriage. However, if such a child was born alive and lived after birth for at least 7 days, he is registered as premature. The rate of neonatal mortality among premature infants is much higher than that among full-term infants, and largely depends on the quality of care medical care in the first minutes and days of a child's life.

Causes of prematurity

All the reasons leading to the birth of premature babies can be grouped into several groups. The first group includes socio-biological factors, including too young or elderly age parents (under 18 and over 40), bad habits pregnant women, malnutrition and poor living conditions, occupational hazards, unfavorable psycho-emotional background, etc. The risk of premature delivery and the birth of premature babies is higher in women who did not plan pregnancy and neglect medical support for pregnancy.

The second group of causes is a burdened obstetric and gynecological history and the pathological course of this pregnancy in future mother. Here highest value have a history of abortion, multiple pregnancy, gestosis, hemolytic disease of the fetus, premature detachment of the placenta. The reason for the birth of premature babies can be short (less than 2 years) intervals between births. Often, premature babies are born to women who resort to in vitro fertilization, but this is not due to the very fact of using ART, but rather to the "female" factor that prevents fertilization in a natural way. Gynecological diseases and malformations of the genitals adversely affect pregnancy: cervicitis, endometritis, oophoritis, fibroma, endometriosis, bicornuate saddle uterus, uterine hypoplasia, etc.

The third group of causes that disrupt the normal maturation of the fetus and cause an increased likelihood of having premature babies include various extragenital diseases of the mother: diabetes mellitus, hypertension, heart defects, pyelonephritis, rheumatism, etc. Often premature birth provoked by acute infectious diseases suffered by a woman in late gestation.

Finally, the birth of premature babies may be associated with pathology and abnormal development of the fetus itself: chromosomal and genetic diseases, intrauterine infections, severe malformations.

Classification of prematurity

Taking into account the indicated criteria (gestational age, body weight and length), 4 degrees of prematurity are distinguished:

I degree of prematurity- delivery occurs at a period of 36-37 weeks of gestation; the body weight of the child at birth is 2500-2001 g, length - 45-41 cm.

II degree of prematurity- delivery occurs at a period of 32-35 weeks of gestation; the body weight of the child at birth is 2001-2500 g, length - 40-36 cm.

III degree prematurenews- delivery occurs at a period of 31-28 weeks of gestation; the body weight of a child at birth is 1500-1001 g, length - 35-30 cm.

IV degree of prematurity- delivery occurs before 28 weeks of gestation; the birth weight of the child is less than 1000 g, the length is less than 30 cm. The term "premature with extremely low body weight" is used in relation to such children.

External signs of prematurity

Premature babies are characterized by a number of clinical signs, the severity of which correlates with the degree of prematurity.

Deeply premature babies with a body weight of II-II degree malnutrition), the child's physique is disproportionate (the head is large and is approximately 1/3 of the body length, the limbs are relatively short). The abdomen is large, flattened with a clearly visible divergence of the rectus muscles, the navel is located in the lower abdomen.

In very premature babies, all fontanelles and sutures of the skull are open, the cranial bones are supple, the brain skull prevails over the facial one. Characterized by underdevelopment auricles, poor nail development (nail plates do not reach the fingertips), poor pigmentation of the nipples and areola. The genital organs in premature babies are underdeveloped: in girls there is a gaping of the genital slit, in boys - undescended testicles into the scrotum (cryptorchidism).

Premature babies born at 33-34 weeks of gestation and later are characterized by greater maturity. Their appearance is different pink skin, the absence of a fluff on the face and torso, a more proportional physique (smaller head, higher location of the navel, etc.). In premature babies of I-II degree, the bends of the auricles are formed, the pigmentation of the nipples and areola circles is expressed. In girls, the large labia almost completely cover the genital gap; in boys, the testicles are located at the entrance to the scrotum.

Anatomical and physiological features of premature babies

Prematurity is determined not so much by anthropometric indicators as by morphological and functional immaturity of vital organs and body systems.

The characteristic features of the respiratory organs in premature infants are the narrowness of the upper respiratory tract, the high position of the diaphragm, the compliance of the chest, and the perpendicular arrangement of the ribs relative to the sternum. These morphological features of premature babies cause superficial, frequent, weakened breathing (40-70 per minute), a tendency to apnea lasting 5-10 seconds (apnea of ​​prematurity). Due to the underdevelopment of the elastic tissue of the lungs, the immaturity of the alveoli, and the reduced content of surfactant in premature babies, a syndrome of respiratory disorders easily occurs (congestive pneumonia, respiratory distress syndrome).

The immaturity of the cardiovascular system is characterized by pulse lability, tachycardia 120-180 per minute, muffled heart tones, arterial hypotension (55-65/20-30 mm Hg). In the presence of congenital heart defects (open Botall duct, open foramen ovale), murmurs may be heard. Due to the increased fragility and permeability of the vascular walls, hemorrhages easily occur (subcutaneous, internal organs, to the brain).

Morphological signs of CNS immaturity in premature infants are weak differentiation of gray and white matter, smoothness of the brain sulci, incomplete myelination of nerve fibers, and poor vascularization of the subcortical zones. Muscle tone in premature babies is weak, physiological reflexes and motor activity are reduced, the reaction to stimuli is slowed down, thermoregulation is impaired, and there is a tendency to both hypo- and hyperthermia. In the first 2-3 weeks, a premature baby may experience transient nystagmus and strabismus, tremors, tremors, and stop clonus.

In premature babies, functional immaturity of all parts of the gastrointestinal tract and low enzyme-excretory activity are noted. In this regard, premature babies are prone to regurgitation, the development of flatulence, dysbacteriosis. Jaundice in premature babies is more intense and lasts longer than in full-term newborns. Due to the immaturity of the liver enzyme systems, the increased permeability of the blood-brain barrier, and the rapid breakdown of red blood cells, premature infants can easily develop bilirubin encephalopathy.

Functional immaturity of the kidneys in premature infants leads to changes in the electrolyte balance (hypocalcemia, hypomagnesemia, hypernatremia, hyperkalemia), decompensated metabolic acidosis, a tendency to edema and rapid dehydration with inadequate care.

The activity of the endocrine system is characterized by a delay in the formation of the circadian rhythm of hormone release, rapid depletion of the glands. In premature babies, there is a low synthesis of catecholamines, transient hypothyroidism often develops, in the first days of life a sexual crisis rarely occurs (physiological mastitis, physiological vulvovaginitis in girls).

Premature babies develop early anemia more rapidly than full-term babies, there is an increased risk of developing septicemia (sepsis) and septicopyemia (purulent meningitis, osteomyelitis, ulcerative necrotic enterocolitis).

During the first year of life, the increase in body weight and length in premature babies occurs very intensively. However, according to anthropometric indicators, premature babies catch up with their peers born at term only by 2-3 years (sometimes by 5-6 years). lag in psychomotor and speech development in premature babies depends on the degree of prematurity and concomitant pathology. In a favorable scenario for the development of a premature baby, alignment occurs in the 2nd year of life.

Further physical and psychomotor development of premature babies may be on par with their peers or be delayed.

Among premature babies, neurological disorders are more common than among full-term peers: astheno-vegetative syndrome, hydrocephalus, convulsive syndrome, vegetative-vascular dystonia, cerebral palsy, hyperactivity, functional dyslalia or dysarthria. Almost a third of premature babies have a pathology of the organ of vision - myopia and astigmatism of varying severity, glaucoma, strabismus, retinal detachment, optic nerve atrophy. Premature babies are prone to frequent recurrent

Very premature babies are placed in incubators immediately after birth, where, taking into account the condition of the child, a constant temperature (32-35 ° C), humidity (in the first days about 90%, then 60-50%), oxygenation level (about 30%) are maintained. Premature babies of I-II degree are usually placed in heated beds or in ordinary beds in special boxes, where the air temperature is maintained at 24-25°C.

Premature babies who are able to independently maintain normal body temperature, who have reached a body weight of 2000 g, with good epithelialization umbilical wound may be discharged home. The second stage of nursing in specialized departments of children's hospitals is indicated for premature infants who have not reached 2000 g in the first 2 weeks, and for children with perinatal pathology.

Feeding premature babies should begin in the first hours of life. Children with absent sucking and swallowing reflexes are fed through a gastric tube; if the sucking reflex is sufficiently pronounced, but the body weight is less than 1800 g, the child is fed through the nipple; children weighing over 1800 g may be breastfed. The frequency of feeding premature babies I-II degree 7-8 times a day; III and IV degree - 10 times a day. Calculation of food is made according to special formulas.

At the age of 1 year, children need to consult a speech therapist and a child psychiatrist.

From 2 weeks of age, premature babies need the prevention of iron deficiency anemia and rickets. Preventive vaccinations for premature babies are carried out according to an individual schedule. In the first year of life, repeated courses of baby massage, gymnastics, individual wellness and tempering procedures are recommended.

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Dream Interpretation - Mole

There is a well-known folk omen: "A mole in such a place that you can see it yourself - for worse, but not visible - for good." Perhaps it is this folk wisdom and served as the basis for a mole to appear in your dream.

Or maybe the mole arose in a dream because in real life Have you thought about the symbolic meaning of each mole, because it’s not for nothing that people say: “The more moles, the more unhappy and sicker man"Or" A mole on the nose - to a heart disease, "A mole on the back - to be pneumonia."

A mole may appear in your dream also because in reality you met with your relatives.

Examining a large mole on your body in a dream is a sign that you have a very influential and wealthy relative who is ready to come to your aid at any moment.

If you dreamed that you had moles all over your body, then such a dream is a bad omen. You will have a misfortune from which you will not be able to recover for a long time.

Perhaps such a dream indicates that you have many relatives with whom you should not forget to maintain relationships.

To remove a mole from your body in a medical way in a dream, then in real life you will be able to avoid the danger that threatens you and the evil gossip of your ill-wishers.

If you yourself remove a mole from yourself, then such a dream suggests that in reality you only contribute to circumstances not in your favor, and give food for gossip to your enemies.

If you dreamed that you had a large mole on your forehead, then in real life you will feel worse. Perhaps you will catch an infection from which you will not be able to recover for a long time. Be careful when talking to strangers.

Looking for moles on your body in a dream and not finding them is a sign that you yourself are to blame for the cool attitude of your relatives towards you. If you do not change your behavior, you will soon be left all alone.

If you accidentally ripped off your mole in a dream, then you will soon receive unpleasant news from your relatives, because of which your attitude towards them will noticeably worsen.

Watching how moles grow on your body before your eyes is evidence that in real life many people would like to make friends, and maybe even intermarry with you. Be careful in choosing friends!

Victoria Bradley, 37, was told her daughter would die - the girl was born weighing just 1lbs 6oz (0.623 kg). Francesca Bradley-Karan was born in April, just for two days late, which in the UK is considered acceptable for abortion. Doctors say that this is a real "miracle" - they had to go through serious difficulties in the course of the struggle for the life of the baby.
A premature baby girl whose feet were the size of a penny was born in the UK. Victoria Bradley, 37, was told her daughter was likely to die. But little Francesca Bradley Curran had a huge will to live. But if she had been born 48 hours earlier, she would not have received medical assistance. Under current UK law, babies born before an abortion is still eligible are not considered "viable" due to their low survival rate.
But although the survival rates of such children are low, and their bodies are often underdeveloped, there are exceptions. However, for nine months this "wonder baby" battled meningitis, sepsis and lung problems.

Ms Bradley, from Liverpool, received a memento cast of her daughter's tiny footprints - doctors made them because they didn't expect her to survive.
But now Francesca is alive and well, she was released from the hospital only 17 weeks after birth. Ms. Bradley said, "It's great to finally be home. I didn't think my daughter would be here. It's scary to think that if she showed up just two days earlier, we wouldn't have had anyone to save her."

The nurses allowed the mother to stay with her daughter for just a few hours, and then placed her in isolation in the intensive care unit. She added: “I thought the baby was still more like a fetus. Her skin was translucent and she had no eyebrows or eyelashes. Her eyes were not yet open. She was just unrealistically tiny, horror. We were told that she would not survive. She immediately picked up a bunch of infections."

Currently, abortions in the UK are performed until the 24th week of pregnancy, and only from the 25th week the fetus is considered human. However, under certain circumstances, the pregnancy may be terminated at this time if there is a risk to the mother or baby.
For those born before 24 weeks, doctors are not required to provide care and resuscitation, as they are not considered "viable". But a 2006 study suggested that 19% of babies born at 23 weeks of age survived, leading many to argue that this limit should be lowered.
Last year, the Royal College of Midwives argued that a woman should be able to terminate a pregnancy at any time without fear of criminal prosecution. This position has been heavily criticized, as there is reason to believe that some will want to terminate a pregnancy if the fetus is the "wrong" sex that they would like. The press campaign began after a 24-year-old woman was imprisoned for deliberately induced miscarriage while eight months pregnant.

Ms. Bradley was diagnosed with infertility and was sure that she would never be able to have children due to problems with the ovaries. She and her partner, Paul Karan, 46, were shocked to learn that she had become pregnant. The pregnancy was very difficult, the woman experienced back pain and severe toxicosis, and at 24 weeks she was taken to the Liverpool hospital on April 22, where she gave birth to her daughter naturally.
After placing the baby in an incubator in the intensive care unit, a team of 15 doctors and nurses fought to keep the girl alive. It took 11 minutes before she could take her first breath.

The girl underwent 15 blood transfusions and laser eye surgery to avoid going blind after the scan. In the first few weeks of life, she also had to overcome meningitis, sepsis, two cases of lung failure and kidney problems.
Ms Bradley added: "She just kept getting stronger every day." After eight weeks, she was able to live without an incubator, and this amazed the doctors - they do not stop repeating that it is a miracle that she survived. The proud mother tattooed Francesca's tiny footprints on her wrist to symbolically commemorate her daughter's battle for life.