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The fetuses reach maturity at different stages of pregnancy. Some are ready to be born as early as the 36th week of pregnancy, without showing any signs of prematurity, others “prefer” to stay inside the mother’s womb until the 41st or even 42nd week.
In the latter group, forced birth between 36 and 38 weeks of gestation may indicate a lack of readiness to be born and the appearance of features of prematurity. On the other hand, in the case of children able to live independently at the 36th week of pregnancy, waiting until the 41st week of pregnancy (if it does not occur spontaneously) may have tragic consequences – including intrauterine fetal death, due to insufficient old placenta.
The average duration of pregnancy is 40 weeks from the day of the last period. However, after this – statistically determined time – only 4 percent are born. kids. About half are born before the due date and the rest after. Therefore, when setting the date of delivery, you should use Noegelli’s rules, from the date of the last menstruation by subtracting 3 months and adding 7 days, taking into account the individual pace of development of each child. The rate of growth of the fetus can be assessed by ultrasound examinations. Even an ultrasound examination performed in the first trimester of pregnancy allows to accurately assess the stage of pregnancy and predict the date of delivery.
—Media 6554913 | 1 | 0 | 0 | BE & W — Statistics show that most fetuses reach the ability to survive postnatal already around half of pregnancy. As an additional criterion of the possibility of ectopic survival, the fetal weight was assumed to be about 1000 g. However, in the era of significant development of neonatology, this weight threshold was reduced to 800 g, and recently even to 500 g.
Pre-pubertal newborns go to the intensive care unit. The main complications that can occur are breathing problems (due to immaturity of the lungs), eating problems (due to too little or no reflexes), and circulatory disturbances (due to interrupted fetal circulation). The risk of the syndrome breathing disorders in newborns born before the 25th week of pregnancy, it is estimated at about 90%. Between 28 and 30 weeks of pregnancy, it drops to 70%, and after 36 weeks it drops to just 0,1%. It can also occur in premature babies bronchopulmonary dysplasia. In children born with a weight of 700-800 g, it occurs with a frequency of 65%. In newborns weighing 1200-1500 g, the incidence decreases to 13%, and over 1500 g – to 0,5%.
The above data clearly shows that the younger the child (and thus – the lower its birth weight), the heavier and longer the adaptation period to post-natal life will be. Thus, all medical activities carried out in pregnant women are aimed at minimizing the risk of preterm labor.
Do preterm labor risk factors they include: low socioeconomic status of the pregnant woman, her age, preterm labor in previous pregnancies, nature of work (exposure to stress and physical exertion), smoking, drug use, inflammation and diseases (hypertension, pre-eclampsia, eclampsia, asthma) bronchial disease, hyperthyroidism, heart disease, maternal cholestasis, severe anemia). Other risk factors are: multiple pregnancy, polyhydramnios, gestational diabetes, serological conflict, hemorrhage, premature detachment of a properly seated placenta.
However, there are times when doctors take the risk of terminating a pregnancy early. This happens when the continuation of the pregnancy puts the life of the mother and baby at risk. Then it is more beneficial for the child to come into the world ahead of schedule and to provide him with optimal conditions in the neonatal intensive care unit.
As you can see, it is impossible to clearly answer the question of when the fetus becomes capable of living independently. However, it should be remembered that prematurity is a problem not only immediately after birth. It also affects the further development of the child and his intellectual abilities in the future.
Text: lek. med. Ewa Zarudzka