The entire nation was reeling with happiness and pride after Republic day celebration and here in CMH we got an opportunity to assist Mrs Usha rani, an elderly prime into her motherhood.
Usha rani since her early 20s dreamt of being a mother faced various challenges in her pursuit with lot of disappointments. She saw silver lining in IVF and was overwhelmed after the twin pregnancies were confirmed. Pregnancy is a progressive physiological state where in both the mother and fetus undergoes immense developmental or regressive changes depending upon the health of the mother. Nutritional aspects take even greater leap especially when there is more than one to be born.
Days passed into weeks and months, Mrs Usha was into her 26 weeks of pregnancy, when she suddenly went into active labour and delivered a lifeless and a very frail and debilitated baby of 500 grams. The NICU team sprang into action to resuscitate the baby and to make Mrs Usha Rani’s dream from enfeebled condition to a healthy and a child who would continue to live on. Golden hour management after birth is crucial. The care in first 24 hours determines the survival of the baby and to live a life without disability.
Under normal conditions a baby is expected to be 900 grams by the 26th week, since Mrs Usha Rani was carrying two of them, the baby had gained only up to 500 grams where in the various organs of the baby were in a formative state and not completely grown to function at desired levels or to perform at optimal state.
By 26 weeks of pregnancy, circulatory system is fully functional with all the other blood vessels performing their role. But the lungs are not fully functional so have trouble breathing but are still theoretically viable. This means that even if there is preterm labor, the baby has a good chance of survival with appropriate timely treatment.
The baby on birth was immediately resuscitated and kept on life support system with external oxygen source for an extended duration. The Baby had Apneas that is complete stoppage of breathing which would occur at any point of the day, the dedicated doctors and nursing staff did wonderfully by gradually assisting the immature lungs in its functioning and increasing its capacity to function as expected in a newborn.
Anaemia is most dreaded in premature babies and this was countered with multiple blood transfusions to the baby. The baby’s blood did not display the clotting and bleeding factors at normal ranges leading to transfusion of Plasma and Cryoprecipitate.
Body temperature is an important factor for all bodily functions and a human body maintains it by burning body fat, in this case as the baby’s weight was below normal even for a preterm, the body temperature had to be maintained by an external heat source such as an incubator. Various other important aspects such as immature immune system, jaundice, fluctuating blood sugar and electrolytes levels were managed successfully.
After overcoming all these, the baby was graduated to the most recent development in the new born care the “Kangaroo Mother Care” where in the parents started spending more then 6 hours a day with baby, which strengthened the emotional bonding between parents and baby. Even the father was encouraged to provide kangaroo care and in one such session overwhelmed with the baby’s progress the father named the baby “CHINMAYEE”, thus was born the blessed one giving hope and confidence to many preterm babies.
For those who are interested in numbers, as per WHO, India contributes about 60% of World’s premature births. All births below 37 weeks are premature and the births which happen between 24 to 27 weeks are considered on the extreme side of premature births. Today with the advent of modren medical science and hitech infrastructure coupled with skilled nursing staff and highly dedicated team of doctors which are in the reach of a common man, we at CMH have been able to handle such high risk pregnancies and give hope to new mothers such as Mrs Usha rani.