Complications of Prematurity
Prematurity (birth < 37 weeks) leads to multisystem organ immaturity. Understanding these complications is essential for management and board examinations.
1. Respiratory and Cardiovascular
- Respiratory Distress Syndrome (RDS): Due to surfactant deficiency, presents with a ground-glass appearance on CXR.
- Bronchopulmonary Dysplasia (BPD): Chronic lung disease associated with prolonged oxygen/ventilator support.
- Patent Ductus Arteriosus (PDA): Failure of the ductus to close; characterized by a machinery murmur and wide pulse pressure.
2. Neurological and Gastrointestinal
| Complication | Key Feature |
|---|---|
| IVH (Intraventricular Hemorrhage) | Occurs in the germinal matrix; often asymptomatic or sudden deterioration. |
| NEC (Necrotizing Enterocolitis) | Most common GI emergency: pneumatosis intestinalis on X-ray. |
3. Ocular and Metabolic
- Retinopathy of Prematurity (ROP): Abnormal vascularization of the retina; the primary risk factor is hyperoxia.
- Metabolic: Hypoglycemia (depleted glycogen stores), hypocalcemia, and hypothermia.
NEET PG Hint: Remember the “VSD” association with NEC (Necrotizing Enterocolitis): Ventilator usage, Sepsis, and Decreased perfusion. For ROP, remember that “less is more” with supplemental oxygen. Prophylactic Indomethacin or Ibuprofen is used to close a hemodynamically significant PDA.