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Today's assignment Houston takes us to Ben tops neonatal intensive care unit. We'll show you what happens to an infant when it's born premature or with a birth defect. Dr joseph Garcia prats is a neonatologist and the medical director for the neonatal intensive care unit at Ben

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Taub Hospital. He explains the role of the neonatologist. The obstetrician delivers the babies. And then if the babies have problems, then the role of the neonatologist is to deal with those issues that the medical problems that they have after they're born. And those problems can be

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uh problems of immaturity where the babies are very very immature when they're born and have immature organ systems, immature lungs, immature heart immature brain kidneys intestines. We have to deal with those problems as the babies get older and shortly after they're born, we took a closer

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look at the infants and this intensive care unit. This little baby here is now about right around two months of age. Um he was he was born quite small and had one of the major complications of our small babies that is highland membrane disease. Uh treatment

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with for highland membrane disease is now quite good. The march of dimes did support research into what we call surfactant replacement, which is what immature babies who have highly membrane disease do not have. So they actually receive the medication into their lungs via a tube that's

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in their windpipe. And that has reduced a newborn mortality significantly. Uh it's it's expensive however, and if we could uh we could improve prenatal care but we didn't have so many immature babies born. we could reduce the cost of care on these very small babies. And

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also reduce the amount of time there in the hospital. Now, we'll see a baby in just a little while whose mother had good prenatal care. And yet he was born very early. Uh the trick is not only to reduce the number of immature babies that are

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born, but identify mothers that go into premature labor early, get them to their obstetrician. And the specialists, the specialists were able to keep this baby in the womb for about another 5-7 days. They're able to give them other treatments that would improve the baby's chances. And

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so this baby is doing quite well. So it's it's good prenatal care and then getting the babies or getting the mothers to a specialist. Once they identify that they're going into premature labor and sometimes that can be, that can be kind of subtle. It may just

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be some back pain. Maybe some they may feel as though they're having some gas problems, stomach aches. And so we have to train these mothers and educate them well to know that this is what's happening. Garcia prats explained some of the complications associated with premature birth.

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I try to emphasize to parents whose babies are born premature that that that indeed in itself is a significant problem because the brain is immature and the kidneys are immature and the heart's immature and the intestines. And so we are trying to do what the uterus

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and the process to do very, very well. And that's nourished. And and allow this baby to develop in the womb. Once babies developed or delivered, then we have to do all of those things which mama normally does provide. He'd give fluids, give nutrition minerals, vitamins, provide

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his oxygen for his lungs. And uh, since his lungs aren't doing it, so, it's a significant undertaking. Once babies are born, it's a simulated womb right here. It's a simulated womb. And uh, certainly is not as good as mamas. But uh, we we tend to do

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a good job and that's why prenatal care is so important in in good, high risk of central care becomes critical for these babies. Prenatal care is important, but it's no guarantee there won't be a premature birth. As in the next case, this baby that that the

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positions are are talking about is a baby born to a teenage mom. This is her first child and she had good prenatal care mom was about 25 to 27 weeks. So, so quite early when she went into premature labor, was able to get to the hospital

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in time, was seen by our obstetrical service and our high risk service and they began medications to try to stop her labor. They were able to do that for about three days before the baby delivered, uh, this helped the physicians out significantly because the baby's highland

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membrane disease or lung immaturity was much less severe. And if mom had had good prenatal care and had not gotten to her, um high risk specialists soon enough. So although the baby is right around £2 his chances at this point in time are pretty good. Uh

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he is only about 48 hours old. And so he is receiving uh lung support via respirator. He's getting. He has little little catheters or little plastic uh special plastic tubes that go into his little belly button that are in the artery and the vein. And we

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do this early on. It allows us to monitor the baby's blood pressure. It allows us to obtain blood without sticking the baby in any way or disturbing the baby in any way. Uh not only that. Getting all these intravenous fluids through those little catheters because the

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baby, because the baby is immature and we know his liver is not working right. He's getting special blue photo therapy and you can see from the lights that he has, that those just help the yellow jaundice, which is accumulating because his liver is not mature. It

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allows it to be degraded by the light and it helps his liver get rid of that. And so he's receiving that special light therapy. You can see that physicians are spending a good bit of time talking about him. And and that is one of the issues

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of resources. This is a baby that probably is 1% of all deliveries in that group of babies weighing under 1500 g. He's very close to or a little under 1000 g. And so we'll find that his nurse and physician's will spend hours making sure his fluids

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are right. His temperature is right. The antibiotic doses are correct. This special protein solutions and fast solutions that he's getting are are correct. So here's this little little tiny, tiny small little human being who who will will be talked about for for a very long period

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of time by his managing physicians. And then his nurse will spend a lot of time making sure that it all gets done and that she will watch him very very closely during the time he's in the intensive care unit. So a lot of resources into a

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very, very small little baby. So prevention again becomes very important. Now you had said the mom did have good prenatal care is there? Do you know why the baby was born premature? It does not appear that they know and we I think the overall occurrence rate

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of premature delivery in the United States of babies who weigh less than £3.04 ounces is right around 1%. So sometimes of that 1%. Sometimes we'll know it's due to mother's infection, sometimes due to bleeding around the placenta from the placenta. Sometimes it's due to some infection

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diabetes, but a majority time we don't know why she goes into premature labor. This is a huge area of research currently, because if we could understand the initiating factors in premature labor, then we'd have a way to try to stop it. And maybe we could even

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be better at preventing these premature births. As dr Garcia prats mentioned a lot of the times the cause of birth defects is unknown. Here's where the march of dimes steps in each year. They devote millions of dollars to research and prevention of birth defects. When we

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come back, we'll tell you about their latest campaign.