Doctors Lounge - Gynecology Answers
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Forum Name: Gynecology
Question: chance of survival for twins
|jwilliford - Wed Nov 04, 2009 2:20 pm||
im 20 weeks pregnant wih twins, this is my 3rd pregnancy, and so far they are developing at the rate that a single pregnancy would, i went to the doctor last week and he said my cervix was at 24 and when i go back this friday, if it is 15 or less, then they are going to admit me into the hospital, im not sure what he meant by that, if i only have 15 % left or what, but i was wondering what the chances of survival would be if they were born now, and about how long they would have to stay in the nicu
|Debbie Miller, RN - Sun Nov 29, 2009 4:45 pm||
For each week of prematurity the risk is greater. There is a reason 40 weeks is the usual term - babies need that long to finish. If your babies were born early you can usually estimate that they will stay in the NICU for the duration of their anticipated weeks to full term. So, a baby born at 32 weeks might be there for the remaining 8 weeks which would have brought the baby to term. This is just an estimate since each baby progresses at its own rate - some will be ready for discharge sooner; others later. It will depend a lot on the complications your babies might experience related to the prematurity.
If they are relatively healthy it will be a matter of time for them to mature, learn to breathe, suck, swallow and grow. The degree of lung maturity will also be a factor. If your babies look like they will come early your doctor may give you some steroid injections to hasten their lung development.
I suspect the cervical measurements indicate that you may have an incompetent cervix which could mean difficulty in carrying the babies to term. In that case, the doctor would want you in the hospital just in case you deliver suddenly. Nobody can actually say what your babies' odds would be at any particular point of gestation. A baby's chances for survival increases 3-4% per day between 23 and 24 weeks of gestation and about 2-3% per day between 24 and 26 weeks of gestation. After 26 weeks the rate of survival increases at a much slower rate because survival is high already. In addition to survival, there is a risk of disability related to prematurity.
For any infant, it is impossible to predict the likelihood of a significant handicap. (moderate or severe mental retardation, inability to walk without assistance, blindness or deafness). However, some factors increase the risk:
* Extreme prematurity, (23-24 weeks gestation at birth). About 50%. As gestational age increases, the chances of being normal or nearly normal increases dramatically and is similar to the chances for survival.
* Identifiable brain abnormalities which may occur before birth or in the NICU. (such as intraventricular hemorrhage).
* Babies who have been the sickest and/or remained sick for long periods of time (several weeks).
Many premature babies are able to have healthy lives free of disability but not without a good struggle first. All you can do is give them the best care possible, including breastmilk and a good hospital prepared for such critically ill babies.
Good luck in your pregnancy.
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