Medically Verified By: Dr Pratima Thamke, consultant-obstetrics at Motherhood Hospitals, Kharghar and Dr Anish Pillai, lead consultant-neonatology and pediatrics
A baby faces multiple complications associated with extreme prematurity, including respiratory distress syndrome, patent ductus arteriosus (PDA), anemia of prematurity, chronic lung disease, and retinopathy of prematurity (ROP). (Representational image/Freepik)
The birth of a premature baby is always a complicated medical issue, which often indicates problems with the mother's health. A premature baby is exposed to many health risks, because most of their organs are underdeveloped. As such, they require an extensive stay at the neonatal intensive care unit (NICU), where their health is monitored. Recently, a similar case happened in Mumbai. A micro-preemie was born at just 23 weeks of gestation, weighing over 600 grams. The baby had to spend more than 100 days at the NICU, before being discharged in good health, weighing 2.2 kg. This challenging case was handled by Dr Pratima Thamke, consultant-obstetrics at Motherhood Hospitals, Kharghar; Dr Anish Pillai, lead consultant-neonatology and pediatrics; Dr Sanju Sidaraddi and Dr Amit Ghawade, consultants- neonatology and pediatrics, along with their team of NICU junior consultants, staff and nurses. Read on to find out more about the case.
A 37-year-old first-time mother experienced mild spotting during her first trimester of pregnancy. Naturally, it was alarming, but with rest and proper care, the situation was stabilised. At 22 weeks of pregnancy, the mother-to-be started to experience 'heaviness' in her lower abdomen along with 'unusual discharge'. Some tests were done that showed that her cervix (the opening of the uterus) had 'shortened' to 2.8 cm, with signs of opening, which increased the risk of preterm labor. To prevent this, doctors performed a cervical cerclage -- procedure where the cervix is stitched to keep it closed during pregnancy -- and advised strict bed rest with medication to control the contractions.
At 23 weeks of pregnancy, however, things took a turn for the worse. The mother developed a urinary tract infection (UTI), and noticed some pain and discharge. She received treatment and injections to help the baby's lungs develop, but her condition only worsened. Five days later, she experienced heavy bleeding; doctors found out the stitches had cut through her cervix, which had started to open once again.
After a detailed discussion with the patient and her family, the team of doctors decided to proceed with an emergency preterm vaginal delivery. They very well understood the risks associated with a preterm birth, including the chance of losing the baby.
But, at 23 weeks and five days, the patient delivered a baby boy weighing just 680 grams. Babies born this early -- before 24 weeks -- have a very low chance of survival, since their organs -- such as the lungs, brain, and the immune system -- are still very much underdeveloped.
In a statement shared by the hospital, Dr Thamke said this case highlights the 'critical importance' of early intervention and continuous monitoring during high-risk pregnancies. "From addressing [the mother's] complications during her first trimester to managing the challenges of extreme prematurity, this journey underscores the need for vigilant care and tailored medical solutions. It is immensely fulfilling to witness a positive outcome for both the mother and the baby..."
Dr Pillai pointed out that a baby's internal organs are extremely immature before 24 weeks of gestation. Caring for them during the initial few weeks, therefore, is very challenging. "The best neonatal units across the globe report a survival rate of 30-40 per cent for infants born at 23 weeks gestation."
According to the doctors, a baby faces multiple complications associated with extreme prematurity, including respiratory distress syndrome, patent ductus arteriosus (PDA), anemia of prematurity, chronic lung disease, and retinopathy of prematurity (ROP).
In this particular case, these conditions were 'effectively treated' with medications and timely therapy. Additionally, a minor intraventricular hemorrhage was detected on the first brain ultrasound scan, which resolved over time.
During the baby's stay at the NICU, his care included continuous skin-to-skin contact (kangaroo mother care) and exclusive human milk support. There was a time when the maternal milk was 'insufficient', so doctors ensured that pasteurised donor human milk was provided to the baby for his optimal nutrition.
"Every day in the NICU was a testament to the strength of this little fighter and the unwavering belief of his parents," Dr Pillai said, adding: "Together, we overcame unprecedented challenges, showcasing the power of hope and resilience in the face of adversity."
The baby's health 'steadily improved' over the course of three months, despite an initial weight drop to under 600 grams; he even began to thrive after crossing the 1-kg milestone.
As mentioned earlier, the baby weighed 2.26 kg at the time of discharge, with normal brain ultrasound, hearing tests, and neurological assessment results. As of now, he is able to feed well, and has also gained weight.
