Проектная работа студентов колледжа "Медицина поистине есть самое благородное из всех искусств" - "These babies are born too soon, but they are not born to die"
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These babies are born too soon, but they are not born to die. Their deaths are utterly preventable.

                                                                                                                                                        Dr. Lawn.

To begin with, the word “premature” in the 19th century was not equivalent to what we mean by “preterm.” Medical writers instead grouped together all tiny newborns under the category of “premature

and weak infants,” or congenital “weaklings” for short. Such babies were thought suffering from a lack of energy or vitality.

 The first invention of a medical technology directed at premature infants, was an incubator. Its invention was associated with the French obstetrician Stephane Tarnier, who in the 1870s developed  a means to warm the numerous premature infants. It was a device for the care of infants similar to the chicken incubator at the Paris zoo.  Tarnier’s first incubator housed several infants who were warmed over a hot-water reservoir attached to an external heating source.

The active treatment of very ill or premature infants was not generally undertaken by doctors until the 20th century. The physicians who specialize in the care of very sick or premature babies are known as neonatologists.

Neonatologists  treat infants with a wide variety of complex medical disorders. Infants born with infections or to drug-addicted mothers are treated in a neonatal intensive care unit (NICU), if the medical situation is severe or possibly in a special care nursery for infants who are less severely ill. Conjoined twins, infants with heart conditions and other medical disorders such as genetic disorders, breathing disorders, metabolic disorders and feeding disorders need neonatal care. Sometimes, neonatologists work with surgeons who specialize in surgery on the very young infants.

The majority of infants cared for by neonatologists are preterm. A premature birth occurs when a baby is born before 37 weeks of pregnancy (full term is 40 weeks). The causes of premature births are not fully known. The risk of preterm delivery varies considerably. Some women have several times the risk of others. For example, women with a previous preterm delivery have two to three times the usual risk of having a preterm infant in a subsequent pregnancy. Some risk factors can be controlled (such as alcohol, cigarette smoking and illicit drug use), but other factors, such as age, multiple gestation, and uterine abnormalities, can’t be controlled. Most preterm deliveries occur spontaneously but are sometimes the result of a doctor`s decision due to health concerns for the baby or mother.

A variety of factors can affect the growth of children born prematurely. Growth is determined by a combination of heredity and nutrition, and can be influenced greatly by prenatal and postnatal circumstances.

Infants as small as 450 grams and as early as 22 weeks gestation have a small but calculable chance of survival. Advances in neonatology have made it possible for the survival of infants weighing at least 2 pounds (1000 grams) and at 27 weeks gestation up to 95% of the time.

In developed countries premature infants are usually cared for in a neonatal intensive care unit (NICU). In the NICU, premature babies are kept under radiant warmers or in incubators, also called isolettes or couveuse, which are bassinets (A bassinet, bassinette, or cradle is a bed specifically for babies from birth to about four months, and small enough to provide a "cocoon" that small babies find comforting.) enclosed in plastic with climate control equipment designed to keep them warm and limit their exposure to germs. Modern neonatal intensive care involves sophisticated measurement of temperature, respiration, cardiac function, oxygenation, and brain activity. Treatments may include fluids and nutrition through intravenous catheters, oxygen supplementation, mechanical ventilation support, and medications.

Although premature babies usually need to be treated in a neonatal intensive care unit, parents play a crucial role in the healthy development of their babies. In developing countries where advanced equipment and even electricity may not be available or reliable, simple measures such as kangaroo care (skin to skin warming), encouraging breastfeeding can significantly reduce preterm morbidity and mortality.  The technique Kangaroo Mother Care works well for both mothers and babies. Using this technique, the tiny infant is held skin-to-skin on the mother's chest. This keeps the baby warm and facilitates breastfeeding.  Studies show that the mortality rate for babies who benefit from Kangaroo Mother Care can be the same or better than that for babies in incubators. Prophylactic treatments and basic infection control measures are also used to care for preterm infants.

 "People think that preterm babies need intensive, high-tech care, but we have simple methods that really work and would save hundreds of thousands of lives," says Joy Lawn, a neonatal physician.

Preterm birth is the leading cause of neonatal mortality and now the number two cause of child mortality globally. Preterm birth is the world's largest killer of newborn babies, causing more than 1 million deaths each year, yet 75 percent could be saved without expensive, high technology care. World Prematurity Day, November 17 2013, is a global movement to raise awareness of the deaths and disabilities due to prematurity and the simple, proven, cost-effective measures that could prevent them.

 Hundreds of associations, societies, professionals, private sector organizations and individuals come together with events and activities in nearly 50 countries, bringing attention to the global challenge of premature birth.