Why a NICU Stay?

High risk pregnancy?

You've just learned that your baby may need to stay in neonatal intensive care unit immediately or shortly after birth. There are many reasons why your baby may end up needing to stay in the Neonatal Intensive Care Unit (NICU) after birth, some have to do with the health of the mom and some have to do with the health of the baby.

No parent ever wants to go home without their baby but in this case, you do want to make sure that your baby has the highest level of care available. Cook Children’s Level IV NICU is here for you and your family. For an entire century, Cook Children’s has been caring for newborns with some of the rarest and most complicated conditions, so you can trust that we have the expertise you want and expect for your baby.

Conditions in a pregnant mom that can result in a NICU stay

High-risk pregnancy

A “high-risk” pregnancy means a woman has one or more things that increases the changes for an early delivery. If you're pregnant with twins, triplets or quadruplets or you have other health factors, speak to your doctor about any risk or concerns you may have. You'll find more information about high risk pregnancy here.

Early delivery

Early delivery can include water breaking early or early contractions which can’t always be prevented. But taking care of yourself is the best way to take care of your baby. Get more information about ways to possibly prevent early labor.

Preeclampsia

Preeclampsia includes high blood pressure and signs of damage to another organ system, such as your liver and/or kidneys, during the pregnancy. This typically begins after 20 weeks of pregnancy and can occur in women whose blood pressure had been completely normal prior to becoming pregnant. Even the slightest raise in blood pressure may be a sign. Your obstetrician should be regularly monitoring your blood pressure in order to identify potential signs.

Incompetent cervix

Also known as a weakened cervix, this occurs when the pressure the baby is putting on the cervix may cause it the cervix to open before the baby is ready to be born. This can lead to premature delivery, but happens in only about 1 out of 100 pregnancies.

Gestational diabetes

First diagnosed during pregnancy gestational diabetes is similar to type 1 and type 2 diabetes in that it causes blood sugar levels to become too high. When you’re pregnant, your body naturally becomes more resistant to insulin so more glucose is available to nourish your baby. If the pancreas can’t keep up with the increased demand for insulin, both your baby’s and your blood sugars can rise to a dangerously high level. However, this is not permanent and once your baby is born, blood sugar will most likely return to normal fairly quickly.

Premature rupture of membranes

Premature rupture of membranes (PROM) is a rupture of the amniotic sac before labor begins. If this occurs before 37 weeks of pregnancy, it is referred to as preterm premature rupture of membranes (PPROM). This is often due to an infection in the uterus and accounts for 25 to 30 percent of all preterm births.

Placenta previa

Placenta previa occurs when the placenta is implanted either close to or on top of the womb. There are multiple types of this condition including complete, partial and marginal placenta previa.

Complete placenta previa is where the placenta completely covers the opening from the womb to the cervix.
Partial placenta previa where the placenta partially covers the cervical opening.
Marginal placenta previa refers to a placenta that is located next to, but not covering, the cervical opening.

These conditions are often caused by scar tissues in the upper regions of the uterus that can promote growth of the placenta in the unscarred lower segment of the uterus. This can be a result of prior Cesarean deliveries, prior dilation and curettage procedures or any surgery of the uterine cavity. In some cases, it occurs because the placenta grows larger to compensate for decreased ability to deliver oxygen and/or nutrients, or a need for greater function.

Placental abruption

Placental abruption is the separation of the placenta from the uterine lining which can interrupt the transportation of oxygen and nutrients to your baby. This can only truly be diagnosed after birth when the placenta is able to be examined, but there are methods used to try to make this diagnosis during pregnancy such as ultrasound, evaluation of symptoms, blood tests, and fetal monitoring.

HELLP

This condition is named for three features of the condition: hemolysis (breakdown of red blood cells), elevated liver enzymes (liver function) and low platelet counts. This is most common in women who have preeclampsia, but there are instances in which HELLP occurs on its own.

Conditions in a baby that can result in a NICU stay

Gastroschisis

This occurs when an opening forms in the baby’s abdominal wall while it is in the womb. The bowel then pushes through the whole and develops outside the baby’s body in the amniotic fluid. Due to the bowel now being unprotected, it can become irritated, swollen and damaged. The condition develops early in the pregnancy and can be repaired with surgery after the baby is born. Learn more about how gastroschisis can be repaired.

Diaphragmatic hernia

A diaphragmatic hernia happens when your baby’s diaphragm has a hole in it because it has not formed properly in the uterus. This hole means that the organs in your baby’s tummy can push through the muscle and crowd the lungs, preventing them from developing properly.

Congenital Hyperinsulinism

Congenital Hyperinsulinism (CHI) is the most common cause of hypoglycemia (low blood sugar) in infants, as well as children. If this rare, and often severe, disorder is not treated, these children are at risk for seizures of even permanent brain damage.

Intrauterine growth restriction

Intrauterine growth restriction (IUGR) refers to a condition in which an unborn baby is not growing at a normal rate inside the womb, causing it to be smaller than it should be. This delayed growth can put the baby at risk of certain health problems during pregnancy, delivery, and after birth such as low birth weight, decreased oxygen levels, hypoglycemia, and more. The most common cause is an issue with the placenta not providing enough nutrients and/or oxygen to the baby.

Congenital heart defect

Congenital heart defects are the most common type of birth defect, but they can now be detected before the baby is born through a fetal echocardiogram.

These conditions with the baby’s heart are formed in the first few weeks of pregnancy and continue to be present at birth. There are many different types and can involve the interior walls of the heart, the valves inside the heart and the arteries and veins that carry blood either to the heart or out to the body.

Our NICU has a state-of-the-art cardiology unit for newborns who require heart surgery. An entire team of neonatologists, cardiologists, cardiothoracic surgeons and neonatal and cardiac nurses monitor your baby around the clock.

What is a preemie?

A preemie, or premature infant, comes into the world earlier than full-term babies. Prematurity occurs when a pregnancy lasts less than 37 weeks; full-term infants are born 27 to 42 weeks after the mother’s last menstrual period. Thanks to recent medical advances, most premature babies survive. Find out more about how to parent your preemie

What is a micro preemie?

A baby that is born before the 26th week of pregnancy or weighs less than 28 ounces (700-800 grams) is considered a micropreemie. Due to their very small size and birthweight, and the fact that they are in very early stages of development, micropreemies have a considerably higher risk of complications than premature babies. Our neonatology team has cared for babies born as early as 22 weeks and weighing only 15 ounces