Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

7 Cheshvan 5766 - November 9, 2005 | Mordecai Plaut, director Published Weekly










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Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Director, Emergency Services, Bikur Cholim Hospital

More letters! Why do miscarriages occur? They can occur for many reasons, such as trauma to the pelvic or abdominal region, but more likely is that the fetus was unlikely to survive in any case due to genetic problems. Occasionally it can also be from incompetent cervices — the neck of the womb — or there may be a tendency to this.

Sometimes babies are born early but are not miscarriages — these are called premature infants, or preemies for short. In Israel they are called pahgs, and the place where they are nursed back to health is called a Pahgiya. In the USA the place where preemies are helped is called the NICU (Neonatal ICU).

A full term infant comes out between 37-42 weeks. Babies who stay in longer tend to be heavier, and this may be the case in babies of mothers with diabetes.

Before 37 weeks is less than full term and every week less than 37 is more dangerous, with less than 23 weeks being usually 100 percent fatal.

What is the problem? Basically lack of development. They have little fat so they need to be kept warm, and that is why they end up in incubators. They can not suck very well and have a tendency towards necrotizing enterocolitis, a vicious intestinal disease, so they must be fed carefully, often through a tube — called in Israel a zonde, and in the USA an NG tube.

Jaundice is a common problem, one which we have spoken about before — and for which UV light is the treatment. Anemia is a problem as their hemoglobin is very immature, and the ability to transport oxygen is limited. Transfusions may be necessary.

Breathing is a special problem. There is a lining to the lung units called surfactant that allows oxygen to pass through the lung membrane into the blood system, and in preemies it is often absent or poorly developed. One of the medical miracles is that this substance has been synthesized and is life saving.

Infections are common since such babies have very limited disease-fighting capability. You have to wear very sterile clothes before handling such babies.

What causes prematurity? Again, trauma, infection, toxemia of pregnancy, twins or triplets. Or it can be the mother's fault: smoking, poor nutrition, and poor prenatal care can be a cause.

Most preemies do catch up and live normal lives. My medical experience has found preemies easier to deal with then teenagers!

Advice on how to keep your brain sharp: I will say this — stay away from stroke. That is, keep diabetes in control, as well as blood pressure, and keep exercising your brain. For our culture this is not much of a problem as the learning we do is protective. Write me in care of the Yated.

A message from GlaxoSmithKline, sponsor of this column. Bactroban is a good medication to fight superficial infection. This medication was a breakthrough for impetigo, but it has uses in burns and infected wounds as well. It has stood the test of time. There have been no similar drugs made and no need for them. It is the best.


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