Maya premature infant’s tale of survival is an extraordinary one. The micro preemie, who was born prematurely at just 24 weeks of gestation (five and half months) and weighed only 520 grams , fought for three-and-half months to survive a stormy course in the neonatal ICU of Jivanta Children’s Hospital , Udaipur , the hospital claims that this is the smallest born preterm baby to ever survived in the state of Rajasthan.
Born to couple Maya and Dev Singh (name changed) from Narnaul, Haryana married for 18 years. She started premature labour pains and leaking of amniotic fluid at 24 weeks of her pregnancy.
The ultrasonography revealed nearly absent amniotic fluid. Couple rushed to Udaipur and as the survival of baby was getting compromised was taken up for emergency caesarean section.
Twin babies were born weighing just 520 grams and 480gms at birth on May 29. These babies were very precious and the only hope for the family.
The baby required artificial breathing support to regularise her breathing and then quickly transferred to Jivanta neonatal ICU.
However, the 480 gram baby was detected to have major brain haemorrhage shortly after birth, and its treatment was discontinued on the parents consent.
“To salvage a baby of this size is mammoth task and big challenge. At the best of centres, only 30 per cent of such babies born this early survive. Most doctors don’t even attempt to save such babies, as the possibility of a healthy survival rate is low,” said Dr S K Tak.
“There is no documented record of the survival of a baby born so early on and weighing this low in Rajasthan. The last reported smallest baby survived in Rajasthan was Baby Geeta (607 grams and born at 27 weeks) at Jivanta children Hospital,” said Dr R K Agrawal.
Dr Pradeep Suryawanshi , Senior Neonatologist from Pune added, “Baby born this small have extremely poor function of all body organs include lungs, heart, brain, kidney, skin, intestine and all of them need support for survival of baby. “
He further stated, “This is where skilled and dedicated neonatologist and nursing staff is required, as the margin of error is close to zero. Problems related to any single system can singularly kill the baby and there is only 5-10 per cent chance of survives without brain damage.”
The baby was managed and looked after at Jivanta Neonatal ICU under precise care of Neonatologist Dr Sunil Janged, Dr Nikhilesh Nain and trained nursing staff.
Initially, the baby was struggling to breathe, and hence was put on ventilator and given surfactant to expand tiny immature lungs.
The baby was having infection in the blood and his haemoglobin level was very low at birth, due to this blood transfusions were required.
His heart functions and pumping was poor. He also had large connection between two major vessels (patent ductus arteriosus), which was closed with the help of medicines.
To get venous access umbilical lines were put. Such babies’ losses water very quickly through their parchment like skin and their weight drops down further.
These are some of many problems one faces while managing such babies.
Regular screening of heart and brain were performed to rule out any bleeding in brain.
Due to brain immaturity baby used to forget to breathe, we call it as apnoea of prematurity. Baby required ventilator support for 70 days.
In all he was in NICU for 102 days, today he is being discharged, on discharge his weight is 1.710 Kg.
By far his progress in NICU is satisfactory, brain is structurally normal, eyes are developing normally.
“In last 2 years Jivanta has successfully treated more than 75 extreme premature babies weighing less than 1000 grams and having more than 90 per cent survival of extremely low birth babies” said Dr Sunil Janged , Chief Neonatologist at Jivanta Children Hospital.