Saving Extremely Premature Babies

Dive Deeper

Medical advances worldwide have made it possible to save extremely premature babies at earlier and earlier ages making the age of viability younger and younger. Years ago, doctors were surprised to save children born at 21 weeks after conception (23 weeks gestation). Now, treating children at 21 weeks after conception has become more commonplace.

19
Weeks
Currently, pioneering medical teams are attempting to save children in the 19th and 20th week after conception (21 and 22 weeks gestation). Survival rates for babies born 20 or 21 weeks after conception are much higher in hospitals that have invested in special equipment and training.1
Premature baby in an incubator.  The baby's breathing, blood pressure, temperature and eating are closely monitored. (Image Credit: Science Source)

Many technological advances have increased the chance of survival for extremely premature infants. These infants’ lungs are underdeveloped. Mature lungs are full of tiny air sacs, called alveoli. Oxygen and carbon dioxide move into and out of the blood in the alveoli. The alveoli resemble balloons. To keep the alveoli from sticking shut when a person exhales, the body produces a substance called surfactant that helps the alveoli reopen.  Extremely premature infants do not produce enough surfactant, so doctors use a synthetic surfactant to help the alveoli stay open.2 Furthermore, doctors also help extremely premature infants create more of their own surfactant by giving the mother an injection of corticosteroids before anticipated preterm birth. The corticosteroids help the lungs mature more quickly, helping the infants breathe better outside the womb.3

Extremely premature babies often have trouble regulating their temperature, so special incubators and blankets keep them warm. Their blood pressure and blood flow are closely monitored, as is their nutritional intake. Special measures are taken to protect their eyes and skin from light and friction.4

As more hospitals invest in medical equipment needed to save babies at the edge of viability, and as they train their obstetrics and neonatology teams to treat these miraculous patients, more and more of them will survive,5 bringing joy and hope to many families.

This premature baby girl was born at 26 weeks and 6 days gestation, weighing about 990 grams. This photo was taken about 24 hours after her birth. A mechanical ventilator helps her breathe in the neonatal intensive-care unit. (Image Credit: Chris Sternal-Johnson, May 30, 2009)