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24 weeker - how bad is it?

NICU   (20,690 Views | 35 Replies)

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a friend of mine has just had her baby at 24 weeks 4 days. as a theatre nurse, all I know of preemies is their tendency to develop NEC, so can someone please give me the lowdown - obviously this is not good, but how bad is it? what can she expect?

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NeoPediRN has 6 years experience and specializes in Pediatrics, ER.

945 Posts; 17,458 Profile Views

The survival rate for a 24 weeker is about 40%. Survival does not guarantee quality of life...24 weekers face extreme odds, including intraventricular hemorrhage, prolonged mechanical ventilation including tracheostomy, chronic lung disease, retinopathy of premature, NEC, cerebral palsy, chronic developmental delay, several oral aversion and feeding tube placement, and a host of other medical complications. I would encourage you and your friend to seek medical advice as well as your own independent research. I wish your friend and her newborn the very best of luck.

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babyNP. has 12 years experience as a APRN and specializes in NICU.

4 Followers; 1,862 Posts; 28,373 Profile Views

40% seems rather low; where are you getting your numbers from?

OP, check out this site from the NIH: http://www.nichd.nih.gov/about/org/cdbpm/pp/prog_epbo/epbo_case.cfm

It has the data from kids based on gestational age, birth weight, singleton/twin, antenatal steroids, etc etc and what percentage of kids have died, have CP, etc etc.

Was the baby born in the United States? (I just ask because you wrote "theatre" and we usually say OR in the US)

The best thing mom can do for the baby is to pump breast milk. It dramatically decreases the incidence of nec, which can kill a baby from healthy to dead in 12 hours or less. There are studies saying that you should keep micropreemies midline (head and body together while positioned) for the first 3 days to prevent head bleeds (intraventricular hemorrhage) that has been adopted by many NICUs. There are a million and one other things, of course, but these are probably among the most important.

I wish your friend well--it's a roller coaster ride for parents and she may feel overwhelming guilt that is misplaced and it's good that you can be there for her.

edit: Nearly all head bleeds occur in the first week of life, so that's the most critical for the baby neurologicalloy...

edit2: Just putting some numbers into the site, a 24 weeker at 700 grams, female, singleton, got antenatal steroids has a 72% chance of survival and 59% chance without profound neuro delays.

Edited by babyNP.

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NeoPediRN has 6 years experience and specializes in Pediatrics, ER.

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BabyRN, I read the data on the study you provided and it seems biased as it states the 4446 infants were between 401-1000 grams, but doesn't break it down to know the median weight...if 4000 were 900-1000 grams and only 446 were less than 900, that would sway the actual survival rates as a 1kg baby obviously has better survival odds than one that is 500 grams. I wish it provided more detail.

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307 Posts; 6,016 Profile Views

thanks all for your information, bleak(ish) as it is.

BabyRN, no, I'm not in the US, I'm in Australia. my friend is also in Australia but on the other coast, so I don't get to see her much at all and have only sketchy information and one photo to go on.

Baby is ventilated and in the photo looks like she's lying on the side, though the lid is off her crib so it might just be that they're doing something with her. other than that, she looks like a micro preemie - little, red and underdone. she was only born yesterday, but so far everything's as good as can be expected.

thanks again for your interest and your information. much appreciated.

Edited by goats'r'us
Saving the world from enormous blocks of text, one giant paragraph at a time

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307 Posts; 6,016 Profile Views

I can now add that she tips the scales at a mighty 680g (1 1/2 pounds to you imperials), and I've decided this is pretty good for a girl of her development. well, it's better than 400g...

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NeoPediRN has 6 years experience and specializes in Pediatrics, ER.

945 Posts; 17,458 Profile Views

Goats, as bleak as the prognosis seems, we see babies beat the odds everyday. There is nothing more resilient than a child.

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GoddessLilithLPN has 6 years experience and specializes in Specialty Oncology Pharmacy.

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My twin and I were born at 23 weeks gestation in 1984. We both survived and are completely healthy. My twin unfortunately developed ROP and now is completely blind. She has had her right eye removed due to severe glaucoma and can't see anything out of her left eye. She was in the NICU for the 4 months after birth and sent home with o2, I was in for 3 months after birth. Other than her having the ROP, we are both completely healthy..it's weird actually, I can see scars on both of our wrists from all the ABGs they did in the first few months of life. So think positively...things always turn out okay:)

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NeoPediRN has 6 years experience and specializes in Pediatrics, ER.

945 Posts; 17,458 Profile Views

My twin and I were born at 23 weeks gestation in 1984. We both survived and are completely healthy. My twin unfortunately developed ROP and now is completely blind. She has had her right eye removed due to severe glaucoma and can't see anything out of her left eye. She was in the NICU for the 4 months after birth and sent home with o2, I was in for 3 months after birth. Other than her having the ROP, we are both completely healthy..it's weird actually, I can see scars on both of our wrists from all the ABGs they did in the first few months of life. So think positively...things always turn out okay:)

You have an incredible story, no doubt, especially for the progress of NIC medicine at that time...but I caution you in saying "things always turn out okay" because they do not a lot of the times....micropreemies can and do live, but are often left with devastating complications of prematurity and parents' dreams of having that "perfect normal child" have been shattered. They are so grateful to the NICU for saving their child, but are also exhausted knowing how long the road ahead is at home.

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loriangel14 is a RN and specializes in Acute Care, Rehab, Palliative.

1 Follower; 6,923 Posts; 36,881 Profile Views

My daughter was born at 24 weeks. She weighed 750grams and went down to 680 before rebounding.She is now a completely healthy 19 year old in her second year of university.

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