A micro-preemie born at just 23 weeks of gestation, weighing over 600 grams fought a battle for over 100 days in the Neonatal Intensive Care Unit (NICU), and was discharged in good health, weighing 2.2 kg.
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, Neha 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 labor. 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 at Motherhood hospitals in Kharghar.
“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, adding, “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.”
“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% for infants born at 23 weeks gestation” said Dr Anish Pillai, Lead Consultant Neonatology and Pediatrics, Motherhood Hospital, Kharghar.
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 specialized 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. Anish Pillai, adding, “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”
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 specialized neonatal care. It serves as a beacon of hope for families navigating similar circumstances.
