Necrotizing Enterocolitis (NEC)
Necrotizing Enterocolitis (NEC) is a gastrointestinal disorder that affects mostly premature babies. NEC involves the infection and inflammation causing destruction of the bowel. "Necrotizing" means the death of tissue, "entero" refers to the small intestine, "colo" to the large intestine, and "itis" means inflammation. NEC is the most common and serious gastrointestinal disorder among hospitalized preterm infants. The exact cause of NEC is unknown, but several theories exist.
It is thought that the intestinal tissues of premature infants are weakened by too little oxygen or blood flow, and when feedings are started, the added stress of food moving through the intestine allows bacteria that are normally found in the intestine to invade and damage the wall of the intestinal tissues. The damage may affect only a short segment of the intestine, or it may progress quickly to involve a much larger portion.
Patent Ductus Arteriosis (PDA)
Patent ductus arteriosus (PDA) is a heart condition that is normal prenatatly but reverses soon after birth. Soon after the infant is born and the lungs fill with air, this blood vessel is no longer needed. It will usually close within a couple of days. If the ductus arteriosus does not close, there will be abnormal blood circulation between the heart and lungs.
PDA is common in prematurity and in babies with persistent respiratory problems. Closure with medications can work very well in some situations, with few side effects. Early treatment with medications is more likely to be successful. Although surgery may be necessary and may eliminate some of the problems of a PDA, it can also introduce a new set of problems. The potential benefits and risks should be weighed carefully before choosing surgery.
Persistent Pulmonary Hypertension of the Newborn (PPHN)
PPHN is a life-threatening cardiopulmonary disorder where a newborn infant's system does not adapt to life outside of his mother's body. Normally, with each breath and pump of the heart, the heart pumps blood through the lungs, allowing blood cells to circulate through the lung tissue to exchange waste carbon dioxide gas for inhaled oxygen.
This re-oxygenated blood is then circulated back through our bodies to feed our cells and start the cycle again. For a fetus still in the uterus, however, oxygen is acquired through the placenta, not the lungs. Because the pressure in the lungs is high, the circulation bypasses the lungs, thus sending oxygenated blood directly from the placenta to other organs through the umbilical vein.
When a baby is born and takes its first breath, an automatic switch is meant to occur to allow the infant to survive outside the womb. Pressure in the lungs is supposed to fall, and that special umbilical blood vessel is supposed to permanently close up so that blood flow can be directed through the lungs, allowing oxygen and carbon dioxide to be exchanged in a normal, non-fetal, fashion.
With PPHN, however, pressure within the lungs fails to fall and this switch cannot occur. Although the baby may seem to be taking breaths, the oxygen is not being delivered to the bloodstream. Without oxygen (gas inhaled) and carbon dioxide (gas exhaled) being exchanged through either the placenta or the lungs, carbon dioxide rapidly builds up in the baby's body, and all his organs and tissues quickly become deprived of life-sustaining oxygen.
Respiratory Distress Syndrome (RDS)
Respiratory Distress Syndrome (RDS), also known as hyaline membrane disease, is the most common respiratory disorder in preterm infants. The clinical diagnosis is made in preterm infants with respiratory difficulty that includes breathing fast, retractions of the flexible rib bones, grunting and nasal flaring with each breath the baby takes.
These symptoms of RDS usually present themselves at birth or within a few hours of birth. Some cases of respiratory distress syndrome are quite mild, and others can be very serious. RDS is treated differently depending on severity. Sometimes with close monitoring, the RDS can be resolved by just giving the lungs times to develop surfactant. Surfactant is a chemical produced by the body that keeps the alveoli in the lungs open, so they can fill with air and work efficiently. Because the lungs don’t start producing surfactant until later in the pregnancy, this is why RDS is common in preterm infants. For those babies with moderate RDS, oxygen therapy may be needed. In the case of severe RDS, surfactant can be given to help the lung maintain inflated as the baby matures.
Retinopathy of Prematurity (ROP)
Retinopathy of prematurity (ROP) is an eye disease that effect low birth weight babies and those born prematurity. ROP is a disorganized growth of the retinal blood vessels which may cause scarring and retinal detachment. Oxygen toxicity and/or the depletion of oxygen supply to the body may be added risk factors for the development of ROP. Although ROP can be mild and resolve on its own, ROP may lead to blindness if not monitored closely. Severe ROP may be treated with laser surgery or intravitreal injection of bevacizumad (Avastin).
Transient Tachypnea of the Newborn
Transient Tachypnea of the newborn is a lung condition in which the newborn’s breathing pattern is more rapid and labored than normal. The rate of babies born with TTN is low and eases within a few days of close monitoring and special treatment. Most babies make a full recovery with no long term affects in their growth or development.