Preterm birth

• Definition: Birth before 37 weeks of gestation
• Causes: Maternal infections, chronic diseases (e.g., hypertension, diabetes), multiple gestation (twins or more), placental problems (e.g., abruption, previa), cervical incompetence (weakness), preterm labor
• Signs and symptoms: Low birth weight (<2500 g), small size for gestational age (SGA), immature appearance (e.g., lanugo hair, vernix caseosa coating), large head relative to body size, thin skin with visible blood vessels, poor muscle tone, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), patent ductus arteriosus (PDA), anemia, infection, hypothermia, hypoglycemia, hyperbilirubinemia

• Assessment: Determine gestational age using Ballard score; measure weight, length, head circumference; monitor vital signs and oxygen saturation; assess respiratory status using Silverman-Anderson index; observe for signs of distress or infection; perform laboratory tests as ordered (e.g., blood gas analysis, blood glucose level, bilirubin level); perform diagnostic tests as ordered (e.g., chest X-ray, cranial ultrasound, echocardiogram)
• Nursing interventions: Transfer the baby to neonatal intensive care unit (NICU) if needed; provide respiratory support as ordered (e.g., oxygen therapy, mechanical ventilation, surfactant administration); maintain thermoregulation by placing the baby in an incubator or under a radiant warmer; monitor fluid and electrolyte balance and administer IV fluids as ordered; provide nutrition support as ordered (e.g., parenteral nutrition, enteral feeding via nasogastric tube or gavage); prevent infection by using aseptic technique and hand hygiene; administer medications as ordered (e.g., antibiotics, steroids, indomethacin); provide developmental care by minimizing stimuli and promoting bonding; educate parents on preterm care and support them emotionally