There has been a gradual increase in preterm births in recent decades. In Greece we have an increase from 7.5% to about 13% in recent years. The most important reasons for the increase in premature births are the increase in IVF births that do not reach full age, the increase in multiple pregnancies and the increase in the age of mothers over 35 years.
The problems that premature infants present are varied and are largely related to how premature they are.
The main problems are the following:
• Respiratory, mainly the Respiratory Difficulty Syndrome (RBS) due to insufficiency of the surfactant, the substance that is necessary for the proper functioning of the lungs. It is treated with the administration of oxygen, mechanical support of the newborn’s respiration with special ventilators and the exogenous administration of surfactant after childbirth.
• Bronchopulmonary Dysplasia, which is observed in very premature infants, less than 1500 gr with severe SAD, who remain for a long time in the oxygen respirator, with consequent disturbance of alveolarity and normal angiogenesis of the neonatal lungs and need special treatment.
• Thermal instability, This is why premature babies remain in an incubator for a certain period of time.
• Food problems, treated with feeding, with a special catheter technique and with special milk for premature infants and breast milk, or when the feeding of the infant is not allowed due to medical problems, with the administration of total parenteral nutrition, intravenously.
• Infections, due to immaturity of the immune system of young premature infants, which can be life threatening and are treated with antibiotics and other special drugs that strengthen their defenses.
• Neonatal jaundice, treated with phototherapy and rarely with blood transfusion.
• Apneas due to prematurity, for which a special drug is administered, caffeine.
• Anemia, which may require a blood transfusion as well as iron administration.
• Neurological problems, such as cerebral hemorrhage, convulsions, etc., which are regulated accordingly and require long-term monitoring of the premature infant for any psychomotor, learning and behavioral problems later.
• Retinopathy due to prematurity, a special eye disease due to retinal immaturity, especially in premature infants weighing less than 1,600 g, which requires very close monitoring by a pediatric ophthalmologist and timely therapeutic intervention with a special laser technique, when necessary .
• Hearing problems, which are checked by screening, with special oto-acoustic emissions, before the newborn leaves the Premature Department.
The birth of a premature baby, especially a very young one, is an unpleasant surprise for the parents and for the wider family environment.
The parents’ contact with the Neonatal Intensive Care Unit (MENN), with the sophisticated modern machines, respirators, monitors, and the sight of their weak, fragile little baby in the incubator, fills them with anxiety, worry, fear and insecurity. sometimes feelings of guilt.
But you should know that science has made huge leaps in the field of Neonatology in recent decades. In addition, the better organization of the Intensive Care Units, their equipment with modern equipment and the staffing with the appropriate nursing staff and specialized Neonatologists, have contributed in recent decades to significantly increase the survival of young premature infants, without at the same time neurological or psychomotor problems of surviving infants.
Thus, today the survival of very young premature infants with a birth weight of 500 g or 25 weeks of gestation is no longer a dream, but a living reality.
Neonatal Intensive Care Unit (MENN) MITERA
MITERA MENN started its operation 42 years ago, on April 27, 1979, together with the then new MITERA Maternity Hospital. It is the first MENN that operated in the field of private initiative and one of the first in the Greek Territory.
It was founded by a group of pioneering Obstetricians-Gynecologists, aiming at the best care of premature and perfect newborns with various problems. With the excellent cooperation and the collective effort of Neonatologists, Obstetricians-Gynecologists, Associate Physicians and Nursing staff, the first good results from the operation of MENN were soon seen, with a significant reduction of perinatal and neonatal mortality to levels unprecedented for the Greek reality.
In these 42 years, about 500,000 newborns were born in MITERA and 85,000 newborns were hospitalized in MENN with a spectacular increase in survival. Statistical data of the Unit presented at an anniversary event for the 40 years of operation:
• The overall survival of newborns born in MITERA reached 99.96%.
• The survival of newborns hospitalized in MENN amounted to 99.82%.
• Perinatal and neonatal mortality decreased dramatically. Especially for the year 2018, perinatal mortality, which includes stillbirths and infants who die in the first 7 days of life, was reduced to 4.23 ‰ (per thousand). Especially the Neonatal mortality that refers to the deaths of infants in the first 28 days of life, in 2018 decreased to the extremely low record rate of 0.38 ‰ (per thousand)!
These data and especially the extremely low Neonatal mortality in MITERA, are equal to the most advanced countries in the world and are an excellent indicator of providing high neonatal care to our young patients.
Writes:
Dr. Meni Saklamaki-Kontou
Pediatrician Neonatologist
Director of the MITERA Neonatal Intensive Care Unit
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