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What are the potential complications for infant born @ 28 weeks? My daughter is 21 weeks pregnant. Scans show the infant is developing normally. Her cervix is opening and thinning and the membranes are showing but not bulging. Her physicians gave two opti

2 doctors weighed in
Dr. Willa Terry
Pediatrics
1 doctor agrees

In brief: Regarding

Regarding the timing of a placement of a cerclage, I do not think that there is clear consensus on the utility at 21 weeks gestation, and the benefit/risk ratio must be weighed carefully and individually for each patient.
In general, the presence of fetal membranes prolapsing through the external cervical os is a relative contraindication to the procedure because the risk of the accidental rupture of the membranes in this setting is great. When premature labor develops and cannot be stopped, the health care team will prepare for a high-risk delivery and immediate resuscitation. The “special care” of a premature infant happens in a neonatal intensive care unit (nicu) and involves the treatment of every organ system in the baby. For example, the preemie baby’s temperature, heart rate, respiratory rate, and oxygen saturation is constantly monitored. Soon after birth, the infant will probably need help via technology to feed, via a feeding tube, and breathe via a ventilator and/or supplemental oxygen administration. In addition, the infant may develop problems with digestion or infections. It is not uncommon for very premature infants to require a blood transfusion at some point during their course in the intensive care unit, and if there is a genetic reason that has contributed to the prematurity, those specific issues will be managed as well. Hospital care is needed until the infant is able to breathe without extra support, feed by mouth, and maintains body temperature and a stable or increasing body weight. Babies born before 37 weeks gestation can have long-term medical or developmental concerns that continue into childhood or longer. In general, the earlier an infant is born and the smaller the infant is at birth the greater the risk of complications. However, it is impossible to predict a baby's long-term outcome based on gestational age or birth weight alone.

In brief: Regarding

Regarding the timing of a placement of a cerclage, I do not think that there is clear consensus on the utility at 21 weeks gestation, and the benefit/risk ratio must be weighed carefully and individually for each patient.
In general, the presence of fetal membranes prolapsing through the external cervical os is a relative contraindication to the procedure because the risk of the accidental rupture of the membranes in this setting is great. When premature labor develops and cannot be stopped, the health care team will prepare for a high-risk delivery and immediate resuscitation. The “special care” of a premature infant happens in a neonatal intensive care unit (nicu) and involves the treatment of every organ system in the baby. For example, the preemie baby’s temperature, heart rate, respiratory rate, and oxygen saturation is constantly monitored. Soon after birth, the infant will probably need help via technology to feed, via a feeding tube, and breathe via a ventilator and/or supplemental oxygen administration. In addition, the infant may develop problems with digestion or infections. It is not uncommon for very premature infants to require a blood transfusion at some point during their course in the intensive care unit, and if there is a genetic reason that has contributed to the prematurity, those specific issues will be managed as well. Hospital care is needed until the infant is able to breathe without extra support, feed by mouth, and maintains body temperature and a stable or increasing body weight. Babies born before 37 weeks gestation can have long-term medical or developmental concerns that continue into childhood or longer. In general, the earlier an infant is born and the smaller the infant is at birth the greater the risk of complications. However, it is impossible to predict a baby's long-term outcome based on gestational age or birth weight alone.
Dr. Willa Terry
Dr. Willa Terry
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