Herculean Task of Saving a 23 Weeks Premature Baby
Babies delivered at the gestational age of 23-24 weeks are considered to have borderline survival potentials their organs are extremely immature. The NICU team at Nanavati Super Speciality Hospital is used to such challenges, having managed to discharge babies as small as 550 grams (26 weeks of gestation).
The Case: Mrs. & Mr. Kujur, are residents of Tarapur, Palghar. The mother, Sunita, a 35-years-old woman with premature onset of labour after 23 weeks of pregnancy was referred to Nanavati Hospital. The baby boy weighing 650 grams was delivered spontaneously in the emergency department. The baby cried after birth, but the breathing was laboured. He was intubated and put on the mechanical ventilator for breathing support wherein he received two doses of surfactant for lung maturity.
The Procedure: The baby boy responded to an initial management of surfactant therapy, ventilation and intravenous fluid. Early enteral nutrition with exclusive breast milk was administered through a feeding catheter which was gradually increased over the next few weeks. The parenteral nutrition was well tolerated.
Over the next 30 days, feeds were gradually increased and breastfeeding was started by 35 weeks of gestational age. The baby boy required a ventilator for 30 days due to premature lungs. At the end of 3 months, the baby was breathing on his own with minimal intermittent oxygen requirement administered intra-nasally.
A presence of ROP was found during regular evaluation of eyes by paediatric Retina Specialist. The infant underwent regular investigation for sepsis and electrolyte levels. He receives a transfusion of packed red blood cells, iron supplements and erythropoietin for anaemia. For the prevention of MBD of prematurity, calcium and vitamin D supplements are given to the baby. In spite of multiple catheters, central lines, prolonged ventilation, the baby did not acquire any major hospital acquired infection (HAI) This is an important measure of the success of infection prevention protocols, especially when dealing with the micro preemie.
The Result: At the time of discharge, the baby weighed 2.7 kg and was on breast feed. He maintained adequate oxygen saturation by breathing normal room air.