Hyderabad, A baby girl with a gestational age of 24weeks 5 days (4 months early)with a birth weight of 550 grams was born to a primi mother with gestational diabetes and hypothyroidism on 6 November 2020 by emergency complicated Cesarian. The child was given appropriate resuscitation, intubated, given surfactant (Curosurf), and connected to a ventilator before shifting to NICU.
The baby was kept on ventilatory support. The baby was extubated on the 3rd day of life and kept on CPAP (ContinousPositive Airway Pressure). After few weeks CPAP pressure support gradually decreased and started cycling with CPAP and HFNC (High Flow Nasal Cannula). Currently, a baby has been self-ventilating on room air and didn’t require ventilator support after day 3 of life.
The baby was started on IV Fluids, TPN, and IV antibiotics. Minimal tube feeds(milk) started from day 2 of lifeand feeds were gradually increased. The baby developed abdominal distension and tenderness, greenish stomach aspirates, and diagnosed to have NEC (Necrotizing Enterocolitis). We treated this infection with appropriate antibiotics and feeds were stopped. The baby improved clinically and feeds were restarted and gradually increased. All feeds were given via an orogastric tube. Eventually, the baby was given paladai feeds and reached full oral feeds. Presently baby is accepting full oral feeds 3 hourly. The baby has been passing urine and stools regularly.
On day 1 the baby had signs of infection (CRP positive). CSF (Cerebrospinal fluid) analysis done and was suggestive of meningitis and treated appropriately. In view of frequent regurgitation of feeds, anti-reflux medications started and continued.
During the initial days, there were metabolic problems like low calcium, low sodium which were treated accordingly. Jaundice was present during initial days and treated with phototherapy.
In view of low hemoglobin (anaemiaof prematurity), the baby was given red cell transfusions during the hospital stay.
Eye screening (ROP) was done at regular intervals as per protocol and was normal. Neurosonogram initially showed grade I bleeding but in the subsequent scans, this bleeding had resolved. Echocardiogram and hearing screeningwere normal. Received vaccination after reaching the appropriate weight.
Dr. Ravinder Reddy Parige said “First time a 24 weeks baby born at Medicover Woman and Child Hospitals. She was very challenging and everyone in our team took great care in looking after this baby. Baby proved to be very strong and managed to pull through all the difficult days. She has no complications related to prematurity as of now and going home today successfully. Currently baby’s weight is 2.32Kg and 140 days old.
I thank all the doctors and nurses in my team who have a major role in this rare achievement and a great success. I thank the Obstetric team, management, administrative staff, and personnel in the lab/blood bank services and all the employees in the hospital for their support and which proved to be invaluable.
Last but not the least; I thank this baby’s parents and family for entrusting us to look after this fragile baby and having confidence in our team. I also thank for their support throughout the stay.”
