children’s hospital – UdaipurBlog

Born at barely 24 weeks, 520 gm baby beat odds to survive

Baby Maya’s tale of survival is an extraordinary one. The micro-preemie, born prematurely at just 24 weeks of gestation [Five and half months] and weighing only 520 grams, fought for three-and-half months to survive a stormy course in the neonatal ICU of Jivanta Children’s Hospital, Udaipur- Smallest ever survived in Rajasthan.

Born to couple Maya and Dev Singh [name changed] from Narnaul, Haryana married for 18 years, she started premature labor pains and leakage of amniotic fluid at 24 weeks of her pregnancy. The ultrasonography revealed nearly absent amniotic fluid. The couple rushed to Udaipur and as the survival of a baby was getting compromised was taken up for emergency cesarean section. Twin babies were born weighing just 520 grams and 480gms at birth on 29th May. These babies were very precious and the only hope for the family. The baby required artificial breathing support to regularize his breathing and then quickly transferred to Jivanta neonatal ICU. However 480-gram baby detected to have major brain hemorrhage shortly after birth, treatment was discontinued on parents consent.

“To salvage baby of this size is a mammoth task and big challenge. At the best of centers, only 30% of such babies born this early survive. Most doctors do not even attempt to save such babies, as the possibility of healthy survival is low.” said Dr. S K Tak.

“There is no documented record of survival of the baby born so early and weighing this low in Rajasthan. Last reported smallest baby survived in Rajasthan was Baby Geeta (607 gm and born at 27 weeks) @ Jivanta children’s Hospital,” said Dr. R K Agrawal.

Dr. Pradeep Suryawanshi added, “Baby born this small have the extremely poor function of all body organs including lungs, heart, brain, kidney, skin, intestines & all of them need support for the survival of baby. This is where skilled & dedicated Neonatologist & Nursing staff is required, as the margin of error is close to zero. Problems related to any single system can singularly kill the baby & only 5-10% survives without brain damage.”

The baby was managed & looked after at Jivanta Neonatal ICU under the precise care of Neonatologist Dr. Sunil Janged, Dr. Nikhilesh Nain & trained nursing staff. At beginning baby was struggling to breathe, so was put on a ventilator & given surfactant to expand tiny immature lungs. The baby was having an infection in blood; his hemoglobin level was very low at birth which required blood transfusions. His heart functions and pumping was poor. The baby also had a large connection between two major vessels [patent ductus arteriosus], which was closed with medicines. His gut was immature & he could not be fed, so the baby was put on TPN which means giving all essential nutrients such as protein, carbohydrate by blood. To get venous access umbilical lines were put. Such babies lose water very quickly through their parchment like skin & their weight drops down further. These are some of many problems one faces while managing such babies. Regular screening of heart & brain were performed to rule out any bleeding in the brain. Due to brain immaturity baby used to forget to breathe, we call it as apnea 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.

“It was a long & tough journey for me & my team; it is the latest technology, the high-end expertise of our NICU team, which has pulled this off. In last 2 years Jivanta has successfully treated more than 75 extreme premature babies weighing less than 1000 grams and having more than 90% survival of extremely low birth babies” said Dr. Sunil Janged, Chief Neonatologist at Jivanta Children Hospital.

A girl child born after 27 weeks of pregnancy with a weight of 607 grams is said to be Rajasthan’s smallest premature birth. Dishika was born a premature to a couple, Geeta and Rajesh Lohar, married for 17 years. She was a twin to her sister who was 1275 grams.

She was born so early that it led to subsequent complications; Dishika had severe respiratory distress, given delivery room CPAP and transferred to Jivanta neonatal ICU on Neopuff. She required respiratory support for a period of about 1 month.

During her course in the hospital, she underwent several functional echocardiograhies and Neurosonographies to assess and modulate her heart and brain development. In addition to this, she also went through ophthalmic examination (ROP screening) frequently. These all procedures were performed by Jivanta’s expert Neonatologist, Dr. Sunil Jangid, under whose supervision she was medicated at Jivanta Hospital’s NICU for almost 85 days.

Dishika’s story started when her mother, Geeta suffered uncontrollable blood pressure and the ultrasonography revealed fetoplacental insufficiency; she was taken up for emergency cesarean section. Geeta gave birth to twin girls and one of them was Dishika. The early birth was followed by a period of uncertainty. Initial days were difficult for the baby as her birth weight dropped down to 500 grams. It was tough to maintain her health as she was struggling to breathe, so was immediately put on a ventilator and given surfactant.

She was started on supportive care like intravenous fluids, parental nutrition, antibiotics. Gradually, she began digesting few drops of milk. She was able to start drinking from spoon only after 10 weeks of birth.

Dishika was called the ‘miracle baby’ by Jivanta’s Team, as she miraculously survived extreme health implications being born as a premature twin. The latest technology, high-end equipment and expertise of the Jivanta’s NICU team made it possible to give life to the smallest preemie of Rajasthan.

Jivanta is now consistently having more than 90% survival rate of extremely low-birth babies.

Dishika is healthy now and is of 2+ years of age. She comes to the hospital for regular follow-up and has normal hearing, normal vision, and normal developmental milestones.