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Another area of prevailing uncertainty is the correct dose. The trans-vaginal suppositories (pessaries) are administered at a dose of 100-200 mg every day. The injectable progesterone (17 alpha-hydroxyprogesterone caproate) is administered intramuscular at a dose of 250mg once a week. The treatment is, ideally, started at 16 weeks. There is evidence that if treatment is started later than 21 weeks, it does not confer any benefit. This is an area of pregnancy management that is likely to continue evolving.
Infant respiratory distress syndrome (IRDS), also called "hyaline membrane disease" affects virtually all babies born before twenty-six weeks of gestation. Between 26 and 28 weeks of gestation, four out of five babies will be affected by this condition, but at thirty-two to thirty-four weeks, the figure falls to only about one in ten and tends to be less severe.
Other short-term concerns include brain haemorrhage and bowel inflammation (necrotising enterocolitis), both of which could lead to serious long-term handicap or even loss of the baby.
Long-term, there is the potential of developing chronic lung disease, eye complications (which, in some cases lead to blindness) and general or localized handicap, resulting from brain haemorrhage. Again, the risk is higher the severer the degree of prematurity.
Of all the problems mentioned, the most frequent and greatest cause of illness and infant loss is the respiratory distress syndrome.
Last update: March 26, 2013