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First days critical for premature multiple births

Doctors' most immediate concerns with premature babies are heart and lung problems  

December 21, 1998
Web posted at: 3:57 p.m. EDT (1957 GMT)

From Medical Correspondent Steve Salvatore

NEW YORK (CNN) -- Premature babies come with a unique set of problems resulting from the early birth. Add multiple births to the mix -- particularly higher numbers as the eight born last weekend in Houston -- and the problems increase.

In multiple birth cases, there are two main concerns: the health of the mother -- traditionally the number one priority -- and the health and survival of the fetuses. Complicating those concerns: the human body is not designed to carry multiple pregnancies.

"When you get up to these high order multiple pregnancies, the uterus is so large. It is so unusual to be able to keep the pregnancy to the point where you deliver and the babies are able to survive," said Dr. Leonard Weisman, chief of neonatology at Texas Children's Hospital.

Some of the octuplets' greatest challenges come in the first 24 to 48 hours after birth.

"Initial problems that we run into in the first few days are lung problems, heart and lung problems," said Weisman. "Once we get through the lung and the heart problems, the next problems we run into are what we call metabolic problems -- sugar, water and salt."

Doctors will be closely monitoring the babies' blood pressure to check for possible shock, and their blood count to watch for anemia. They will also be monitoring "blood gases" to make sure the lungs are providing enough oxygen.

A day at a time

As the days progress, feeding become a concern in premature births. Frequently, the mother's breast milk has not had time to develop, so a special formula is given to the babies through feeding tubes placed in their stomachs.

Another potential complication is bleeding into the brain. The vast majority of these episodes occur within the first 24 to 48 hours. They can range from mild to severe -- severe cases can lead to serious brain injury.

Other possible complications include:

  • A potentially fatal intestinal problem
  • Kidney problems
  • Water loss
  • Inability to stabilize body temperature
  • Eye problems
  • Infection due to an immature immune system

Neonatologists say the chance of survival for fetuses increases dramatically after 28 weeks. A critical moment will be reached when the babies can breathe on their own.

And the bigger the babies are at birth, the better their chances for survival. For now, it's just one day at a time.

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