Childbirth is a life-changing experience. It is an experience that is cherished and looked forward to by parents-to-be. However, one may encounter the challenge of preterm delivery. Due to several cases of preterm birth leading to chronic health problems, myths around preterm births include concerns that the baby could suffer from long-term mental and physical incapability.
Here are some of the instances that dispel the myths and concerns surrounding premature births. Quality care provided at the time of birth can achieve excellent outcomes of ‘intact survival’ in these babies.
Until recently, most medical facilities lacked advanced technology. However, Manipal Hospitals’ neonatal care is equipped with various facilities for newborn care, such as synchronised ventilation, PSV/SIPPV/VG modes of ventilation, high-frequency oscillatory ventilation, inhaled nitric oxide therapy, CPAP, non-invasive ventilation, continuous renal replacement therapy, intense phototherapy, total parenteral nutrition, bedside functional echocardiography, real-time cranial ultrasonography and advanced diagnostics.
One such case was that of Kavya (name changed). The year 1994 earmarked the first-ever application of exogenous surfactant therapy in India. The baby of Kavya, who was born prematurely at 32 weeks in a small nursing home, was found to have severe breathing difficulty on account of his premature lungs.
The baby was immediately transported by his relatives, to the advanced NICU at Manipal Hospital, Bangalore. The neonatal team immediately revived the baby and connected him to a ventilator, despite which his condition remained poor. The team quickly decided to perform the exogenous surfactant therapy to improve the baby’s lung function. This was the first time this procedure was performed in India. Subsequently, after another month of intensive care support, the baby was discharged. Today, the baby is an energetic 26-year-old who has joined his father’s business.
Another distinctive case is that of Kala (name changed) baby. Kala was referred to the high-risk perinatal unit of Manipal Hospital at 26 weeks of pregnancy for safe consignment. It was observed that the foetus was not growing too well in the uterus and was also suffering from high blood pressure. Previously, Kala had aborted thrice and she was understandably anxious about this childbirth. The 27-week-old baby, weighing about 620gms, was admitted in the advanced NICU and was treated under the expert care of Dr N Karthik Nagesh and his team.
Aggressive intervention through ventilation, exogenous surfactant replacement therapy, parenteral nutrition, thermoregulation, intensive care, and other measures were carried out over the next four months for the child. Today, he has blossomed into a brilliant young poet and is currently pursuing journalism, and no longer suffers from the earlier complications.
Similarly, in 1993, a pregnant Neeraja (name changed) was rushed to the hospital due to the severity of her condition. Neeraja delivered her baby at 28 weeks of pregnancy. The baby, who weighed about 1.1 kg at birth and suffered from breathing difficulties, had to be immediately supplied artificial ventilation. The baby also required advanced intensive care support for the next two-and-half months. During this period, a cardiac procedure was also performed to close the patent ductus arteriosus (PDA). The PDA had opened up, obstructing the breathing, making the baby ventilator dependent. The baby also developed a fulminating complication of severe necrotizing enterocolitis due to which the baby’s small intestine had perforated and emergency surgery was needed. Several such complications were circumvented. Post-treatment, the baby’s weight increased to 1.6kg and was discharged.
All these babies were premature and today are all leading healthy lives! Many carry the notion that these babies are born “too soon.” These notions have been proven wrong. With diligent care and support in the Neonatal ICU, the babies have survived well. Quality of care during the tough neonatal period plays a vital role during the crucial period. It ensures intact neurological and developmental function allowing them to perform to their best.
The writer is Chairman & HOD, Neonatology & Neonatal ICU at Manipal Hospital Old Airport Road, Bengaluru.
