Navi Mumbai doctors save the life of 23-week old baby weighing over 600 grams in NICU

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A team of expert obstetricians and neonatologists at a Mumbai hospital have achieved a remarkable milestone by saving the life of a micro-preemie born at just 23 weeks of gestation, weighing over 600 grams. After spending more than 100 days in the Neonatal Intensive Care Unit (NICU), the baby was discharged in good health, weighing 2.2 kg.

The team including Dr. Pratima Thamke, consultant- Obstetrics, Motherhood Hospitals, Kharghar, Dr. Anish Pillai, lead consultant- Neonatology & Pediatrics, Dr. Sanju Sidaraddi and Dr. Amit Ghawade, Consultant- Neonatology and Pediatrics, Motherhood Hospitals, Kharghar along with their team of NICU junior consultants, staff and nurses helped carry out the successful delivery.

The journey started with Neha (name changed), a 37-year-old first-time mother, who experienced mild spotting during her first trimester. With rest and proper care, her pregnancy stabilised. At 22 weeks, the mother started experiencing heaviness in her lower abdomen along with unusual discharge. Tests 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 labour. To prevent this, doctors performed a cervical cerclage (a procedure where the cervix is stitched to keep it closed) and advised strict bed rest with medication to control contractions.
Things took a turn at 23 weeks when Neha developed a urinary tract infection, pain, and discharge. Despite treatment and injections to help the baby's lungs develop, her condition worsened. After five days, Neha experienced heavy bleeding, and doctors found that the stitches had cut through her cervix, which had started to open. After a detailed discussion with Neha and her family, the doctors decided to proceed with an emergency cesarean delivery (C-section), understanding the high risks of preterm birth, including the chance of losing the baby.

At just 23 weeks and 5 days, Neha delivered a baby boy weighing 680 grams. Babies born this early, before 24 weeks, have a very low chance of survival as their organs like the lungs, brain, and immune system are still very underdeveloped.

"This case highlights the critical importance of early intervention and continuous monitoring during high-risk pregnancies," said Dr. Pratima Thamke, Consultant Obstetrician, Motherhood Hospitals, Kharghar, continuing, "From addressing Neha'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 mother and baby, reaffirming our commitment to providing exceptional care at Motherhood Hospitals."

Dr Anish Pillai, Lead Consultant Neonatology and Pediatrics, Motherhood Hospital, Kharghar, said, "The internal organs like lungs, digestive system, brain, and immune system are extremely immature before 24 weeks gestation. Caring for these babies during the initial few weeks 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."

Given the high risk, the medical team's prompt response became crucial. Neha delivered a baby boy weighing only 680 grams, who was immediately placed in the incubator under the specialised care of the Motherhood neonatal team led by Dr. Pillai.

The 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). 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. Throughout his NICU stay, the baby's care included continuous skin-to-skin contact (Kangaroo Mother Care) and exclusive human milk support. When maternal milk was insufficient, pasteurized donor human milk was provided to ensure optimal nutrition during the critical early days.

"Every day in the NICU was a testament to the strength of this little fighter and the unwavering belief of his parents," said Dr. Pillai. "Together, we overcame unprecedented challenges, showcasing the power of hope and resilience in the face of adversity. Over the course of three months, the baby's condition steadily improved. Despite an initial weight drop to under 600 grams, he began to thrive after crossing the 1 kg milestone. By the time of discharge, the baby weighed 2.26 kg, with normal results in brain ultrasound, hearing tests, and neurological assessments. He is now feeding well, gaining weight, and achieving age-appropriate milestones"

Avinash (name changed), who is the father of the baby said, "The love and affection we received from the entire Motherhood team was truly heartwarming. We never felt like patients; instead, our time here felt like being with family. We are deeply grateful to all the experts, because of whom our baby boy is now thriving, even after facing numerous challenges. The dedication and care extended by the staff was remarkable - many who were off duty still came regularly to check on our baby, showing genuine concern and love that went far beyond their professional responsibilities."

The NICU team highlighted the importance of regular follow-ups to monitor the baby's growth and development. This extraordinary case exemplifies the challenges of managing extreme prematurely and underscores the significance of specialised neonatal care. It serves as a beacon of hope for families navigating similar circumstances.