Definitions

apnea: a common health problem in premature babies. During an apnea spell, a baby stops breathing, the heart rate may decrease, and the skin may turn pale, purplish, or blue. Apnea is usually caused by immaturity in the area of the brain that controls the drive to breathe. Almost all babies born at 30 weeks or less will experience apnea. Apnea spells become less frequent with age.

In the NICU, all premature babies are monitored for apnea spells. Treating apnea can be as simple as gently stimulating the infant to restart breathing. However, when apnea occurs frequently, the infant may require medication (most commonly caffeine or theophylline) and/or a special nasal device that blows a steady stream of air into the airways to keep them open

bilirubin: a yellowish substance contained within red blood cells, and released into the blood stream when the red blood cells break down. Bilirubin is normally processed in the liver and excreted in the stool. Because preemies' immature systems cannot process bilirubin very efficiently, levels can build up in the blood and cause jaundice.

bronchopulmonary dysplasia (BPD): is a chronic lung disease of babies, which develops most commonly in the first 4 weeks after birth. It mostly occurs in babies who are born more than 4 weeks before their due dates, though sometimes the babies are full term. In BPD, the lungs do not work properly and the babies have trouble breathing. They need extra oxygen and may even need help from a breathing machine. Doctors think babies get BPD because their lungs are sensitive to something damaging in the environment, such as oxygen, a breathing machine, or an infection. Premature babies are also at risk for complications in other parts of the body that are also not fully mature, including the heart, kidneys, brain, stomach, intestines, and eyes.

With new and better treatments today, most babies with BPD live. In severe cases, the baby may die.

BPD is different from respiratory distress syndrome (RDS), which occurs in the lungs of premature infants, because their lungs do not produce enough surfactant (a liquid material that coats the inside of the lungs making it easy to breathe). In the past, doctors thought that BPD was a disease mostly in babies who survived RDS. They believed that the treatment of RDS with a breathing machine and extra oxygen caused BPD. Today, babies with RDS are treated with surfactant replacement therapy and do very well. With this new treatment, BPD is not common in babies born early and weighing 3 pounds or more.

cerclage: a pursestring stitch to help keep the cervix closed. It is used to prevent miscarriage or preterm delivery in the case of an incompetent cervix. An incompetent cervix is a cervix that opens without labor too early in a pregnancy.

cerebral palsy: a term that describes a group of disorders that affect movement control. There is not one specific cause of cerebral palsy, however, it can be caused by injury to the brain before, during, or after birth.

chorioamnionitis: an infection of the membranes (placental tissues) and amniotic fluid. It occurs in about 1 to 2 percent of all pregnancies, but is much more common in preterm births. It can cause bacteremia (blood infection) in the mother and may lead to preterm birth and serious infection in the newborn baby. Other terms for chorioamnionitis include intra-amniotic infection and amnionitis.

complete blood count (CBC): a laboratory test that measures the cellular components -- red blood cells, white blood cells and platelets -- in the blood. Often done as one of a series of tests to detect infection.

inguinal hernia: An inguinal (meaning in the groin area) hernia forms when a loop of intestine -- or sometimes, in girls, an ovary -- slides down into the groin from the abdomen, through a canal that's open in the fetus, but normally closes during the last few weeks of gestation. Because premature babies are usually born when that canal is still open, or only partially closed, a rise in pressure inside their abdomen, from crying, straining to have a bowel movement, or just breathing hard, can cause a hernia. On average, 15 in 100 preemies develop a hernia, compared to only one in 100 term infants, and the likelihood increases the younger and smaller a preemie was when he was born.

intraventricular hemorrhage (IVH): bleeding within the ventricles of the brain.

jaundice: yellowish tinting to the skin and whites of the eyes caused by high levels of bilirubin in the blood.

micropreemies: Premature babies less than 26 weeks gestation. These babies weigh less than 1 3/4 pounds (750) grams. This group once hand an almost 100 percent fatality rate, but with recent advances in neonatal care, 25-50 percent of these babies now survive. Over half of micropreemies will have a number of long-term problems, such as visual and neurologic deficits and chronic lung problems.

patent ductus arteriosus (PDA): An extra blood vessel connects the aorta and the pulmonary artery. This vessel referred to as a ductus arteriosus is present in all babies at birth. Normally, the passageway between the two arteries closes within a few days of life. Sometimes the vessel fails to close. Blood which is returning from the lungs and is oxygen rich passes through the ductus arteriosus and recirculates back to the lungs. If the vessel is small then the heart has to pump only a small amount of additional blood and there is no strain on the heart. However, if the vessel is large, the heart has to pump the extra blood and will be overworked and may become enlarged. The extra blood flow to the lungs may eventually lead to irreversible damage to the walls of the vessels and obstruction to blood flow. If this happens, surgery is not possible. Therefore, surgical closure of the ductus is necessary in the first year of life. Surgical repair restores the circulation to normal and the longterm outlook is very good.

perinatologist: an obstetrician who specializes in high-risk pregnancies.

periventricular leukomalacia (PVL): damage to part of the brain caused by complications of prematurity that may result in brain cysts. Cerebral palsy is a typical manifestation of PVL.

retinopathy of prematurity (ROP): causes a disease of the retina. It affects prematurely born babies. It consists of abnormal retinal vessels that grow mostly in an area where normal vessels have not yet grown in the retina. ROP is divided into stages 1 to 5. Stages 1 and 2 do not usually require treatment. Some babies who have develop stage 3 ROP require treatment. The treatment is usually performed either by laser or cryotherapy (freezing). Laser is more commonly used now than cryotherapy because of various advances in the laser treatment. The ROP in stage 3 that requires treatment is generally called threshold disease. The majority (95%) of the babies who require laser or cryotherapy develop threshold disease between 32 and 42 weeks after conception.

umbilical arterial catheter (UAC): Catheter (small tube) placed in a belly button artery. It is used to check blood pressure, draw blood samples and give fluids. A UAC will usually be removed no later than 1-2 weeks to prevent clotting or infection.

under the lights: a term referring to phototherapy, or being under bilirubin lights to treat jaundice

vecuronium: a drug used to cause temporary paralysis of muscles and to keep critically ill babies from breathing against, or "fighting," the ventilator; also helps to improve oxygen levels in the blood. Babies receiving vecuronium cannot move, but they can hear your voice and feel your touch.