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When premature labor develops and cannot be stopped by medical intervention, plans for appropriate management of a premature baby and the mother are made, which may involve transport of the mother to a center with facilities to care for premature infants, i.e. a neonatal intensive care unit (NICU). In some cases, steroids may be given to the mother in order to facilitate lung maturity in the premature infant.
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To assure support of the respiratory and cardiac systems and anticipate other common problems associated with prematurity, immediate evaluation and, if necessary, resuscitation takes place after delivery. The infant will be admitted to or transported to a high-risk nursery with personnel trained in the care of premature infants.
The infant is placed under a warmer or in an isolette with controlled temperatures where careful observation and care can be given.
Feeding may be administered by inserting a tube into the stomach, since infants are usually unable to coordinate sucking and swallowing before 34 weeks gestation. Intravenous feeding may be indicated in extremely premature infants.
Depending on the degree of prematurity, the infant may not start breathing after birth, or respiratory efforts may be inadequate to expand the chest and deliver oxygen to the infant's body. In such cases, a breathing tube is inserted into the infant's trachea, and artificial breathing is delivered by a respirator. Supplemental oxygen is given. (See respiratory distress syndrome.)
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