Infants born significantly before term usually require neonatal care until around the expected date of delivery. Following the introduction of surfactant coupled with the widespread use of antenatal corticosteroids in the mid-90s mortality rates for these infants fell significantly although in the smallest the risks of death remained high (Fig. 11.1). Rates in the twenty-first century remain similar to those shown. Mortality in extremely preterm babies can be significantly reduced if hypothermia is prevented at birth; this is only possible if the delivery room is maintained at an appropriate temperature. Most survivors do not suffer long-term disability, but in infants of less than 28 weeks gestation some 20% suffer neurodevelopmental impairment.
The stress on parents and family of having a baby who undergoes intensive care can be immense. They have to suffer prolonged uncertainly about the infant's survival as well as a loss of control over their baby's and their own
lives. Careful preparation of parents, with visits to the intensive care unit and meetings with unit staff may help, but the difficulties for families in this situation should not be underestimated.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.