HYDERABAD: A baby girl born four months early with a birth weight of 550 gm was born to a primi mother with gestational diabetes and hypothyroidism on November 6, 2020 by an emergency complicated Ceasarian. At Medicover Hospitals, Hyderabad, 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 (Continous Positive 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 two of life and 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 one, 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 (anaemia f prematurity), the baby was given red cell transfusions.
The doctors performed eye screening at regular intervals as per protocol and was normal. Neurosonogram initially showed grade I bleeding but in the subsequent scans, this got resolved. Echocardiogram and hearing screening ere normal. Received vaccination after reaching the appropriate weight.Dr. Ravinder Reddy Parige said, “This is this the first time a 24-week baby was born at Medicover Woman and Child Hospitals. She was challenging and everyone in our team took great care of her. The baby was strong and managed to pull through all the difficult days. She has no complications related to prematurity. The 140-day baby weighs 2.32 kg.