UTH CURB VERY LOW BIRTH WEIGHT

BY DAVIES CHUTU

Low birth weight refers to babies born with a weight of less than 2,500grams while very low birth weight are babies born less than 1,500grams.

According to Dr. Chisele an Obstetrician and Gynecologist the weight of a neonate at birth has a significant prognostic value and is a major determinant of child survival. Neonatal mortality and morbidity tends to increase proportionately with reduced neonatal birth weight. He said premature birth is a term for a baby born before the 37 completed weeks of gestation.

Dr.Chisele mentioned that 70% of babies born who are admitted to the Neonatal intensive Care Unit at the UTH labour ward are due to the low birth weight.

He said “the causes of low birth weight in neonates can be multi-factorial. Maternal factors include age, marital status parity, Social economic factors like preterm labour, multiple pregnancy possible complications in the index pregnancy, necessitating pregnancy interruption before term, cervix abnormalities, maternal high blood pressure, smoking during pregnancy, infections in the fetus, inadequate maternal weight gain and women under the age of 17 are at risk of delivering a low birth weight baby. Other causes includes: pre- eclampsia, twinning ante partum hemorrhage and others.

The two other main causes for a baby to be born with low birth weight are premature birth and intrauterine growth restriction.

Dr Chisele further said a baby born with low birth weight, may need to spend additional time in the hospital for close monitoring in D Block which is the neonatal intensive care unit. These can last days, weeks, or months depending on how much the baby weighed at birth and how long it will take for the baby to reach the appropriate weight before being allowed to go home.

Dr. Chisele pointed out that UTH has a specific weight requirement for discharge, but it is not always an absolute number and depends on the underlying causes and issues. In most cases an ultra sound can inform the Doctor before the baby is born that he or she is not gaining weight. The Doctor may want to monitor the fetal heart rate and perform additional ultra sounds to monitor the babies’ progress. Occasionally, a baby may need to born prematurely in order to save its life or the mother’s life due to other medical factors.

He said “The use of progesterone supplementation during pregnancy usually reduce the risk of recurrent preterm birth in women with a history of at least one prior spontaneous preterm delivery, has been considered in some centre’s on trial basis. However, its role in preventing preterm labour still remains unclear”.

The gynaecologist specialist said that physiologically progesterone has been known to reduce the likelihood of uterine contractions. This therefore means, there is a possibility that a woman who receives this supplements during pregnancy may be less likely to go into premature labour and ultimately contribute to a reduction in low birth weight babies.

Antenatal administration of progesterone reduces the risk of preterm birth as well as the risk of a new born being born with a weight of less than 2500g. Management at the University Teaching Hospital has put up measures to introduce giving oral progesterone to mothers who are expecting.

These low birth weight premature infants are born without adaptive mechanisms needed for survival outside the womb. These fragile infants require thermo protective interventions that begin in the delivery room. The treatment is warming babies in incubators. The hospital has acquired the state of art equipment like incubators to accommodate babies who needs special interventions like the premature babies.

He added that premature babies also often have respiratory problems because their lungs are not fully developed. An Infant with breathing problems may be given medicine such as surfactant or mothers are administered with a steroid drug to improve fetal maturity.

Dr. Chisele in conclusion said premature babies may also suffer hypoglycemia a condition in which the amount of blood glucose (sugar) in the blood is lower than normal. Treatment includes infusion with glucose. The baby’s blood glucose is closely monitored after treatment to see if the hypoglycemia occurs again.