INCREDIBLE STORY OF A MICRO PREEMIE

India accounts for 20% of global live births. It accounts for 24% of global preterm births. Prematurity rate in India (birth before 37 completed weeks of gestation) is 13%. 

Approximately 25 million babies are born in India per annum. India’s current infant mortality rate (death before 1 year of age) is 42/ 1000 live births and neonatal mortality rate (death in first 28 days of life, neonatal period) is 29/ 1000 live births. This means 0.72 million neonatal deaths, 1.05 million infant deaths occur in India every year.90% of neonatal deaths occur from preventable causes (prematurity, birth asphyxia,infection, pneumonia and diarrhea)   35% of neonatal deaths are due to prematurity and can be prevented.The number ‘Twenty three’ could sound unimpressive to the common man.  However survival of a preterm infant born at 23 weeks is considered the pinnacle of quality newborn intensive care worldwide. 


Even developed countries would not revive babies premature than this, since the chances of survival and normal development is bleak. When baby Sakshi was born on 5^th May 2015 at 23 weeks of age with a birth weight of 460 grams, (with a length of 30cms and head circumference of 20 cms) no one could have imagined that she would turn out to be the smallest survivor in this country, India. This is the story of an ultimate fighter that the NICU at Surya Mother and Child Care has witnessed over the last 25 years.

Baby Sakshi was born premature at 5.5 months (23⁺¹ weeks) of pregnancy. This child was probably the only hope for Trupti and Santosh after 12 years of marriage and 5 failed attempts at getting pregnant. The delivery was conducted by the obstetric team at Surya Mother and Child Care.  

Parents were counseled prior to delivery regarding possible outcomes of babies born at 23 weeks of gestation. Parents always wanted to take minimum possible chance. Neonatal team at Surya revived this child in the labour room and after initial stabilization, transferred the child to the NICU at 10 min of age. Infant was given one dose of life saving medication surfactant in the lung to help with breathing difficulty due underdeveloped lungs.  Sakshi spent her early months in the midst of tubes, lines, fluids, blood, medications, dressings, monitors and ultrasound scans. She survived all odds to overcome  immature lungs, infection, bleed in the brain, poor growth, drops in hemoglobin, fragile bones  and immaturity of  virtually every other organ in the body. The burden of intensive care was at least 1000 times heavier than the baby herself.  After 6 weeks of ventilator support and 12 weeks of breathing support with oxygen, Sakshi finally got what she always wanted- mother’s cuddle. The incubator in Surya NICU that sheltered Sakshi for the first 3 months was her first house in Mumbai.

It takes much more than sophisticated neonatal intensive care to save such premature babies. Optimal delivery room care, state of the art transport facilities, strict infection control, better infant nutrition, and above all national interest is required to improve survival in such extremely preterm babies. This baby was delivered at Surya Mother and Child care and then retrieved to Surya NICU at 10 minutes of age and was commenced on ventilatory support and adequate nutritional support was initiated at the earliest.  Carbohydrates, fats, proteins and other nutrients were provided ­through intravenous access secured through central lines prior to initiation of milk feeds through feeding tube. However, the most crucial element of this survival experience was the exceptionally meticulous effort by a team of at least 15 doctors and nurses at Surya NICU. It has taken over 85000 person hours of hard work to see Sakshi get to 1.9 kg and take feeds orally without oxygen.

 The smallest reported survivor by maturity in India at 24 weeks of gestation was reported from same hospital in 2011. The smallest surviving triplets reported were also from Surya NICU. Few other survivors have also been reported lately at 24 weeks from some good centers in this country. However, Sakshi is the smallest survivor reported in our country at 23 weeks and 460 grams. Baby is currently doing well, is ready for discharge and will require regular follow up at least until 1.5 years of age

Sakshi’s story highlights the fact that excellence in neonatal care similar to the developed countries is achievable in India despite all odds and economic constraints. Timely in-utero transfer of mother tomaternity centres specializing in newborn care is of utmost importance. Sakshi’s survival should encourage doctors to never give up on an extremely preterm baby born at the limits of viability, because it is hard to predict how small is too small to survive!!!!!

 

Extending Mother Care through WaterBirth at Surya Mother and Child Hospital, Mumbai

Surya Child Care relies on providing expectant mothers path breaking solutions for a complete three sixty degree mother and child care. Thus, Surya Child Care has partnered with distinguished Obstetrician and Gynecologist, Dr. Arneet Dhurandhar (M.D) for establishing the Water Birth facility at SuryaHospital, Mumbai. Dr. Dhurandhar enjoys the peculiarity of being the first consultant in the city of Mumbai to carry out an entirely natural birthing process. 

As expectant mothers, it is essential to understand the minute details of water birth since it can be the best possible choice for you and your bundle of bliss.The mother feels far more relaxed in the procedure since it decreases pain perception by 40-60%. The procedure includes being submerged in water which is regulated at a temperature of 36-37.5 degrees Celsius. It makes contractions more endurable and the mothers are less probable to need analgesic drugs (painkillers). The buoyancy keeps the mother afloat in water (Archimedes Principle) and helps her maintain a relaxed position suitable for the procedure. The baby, which is born with water birth as a process, will be born into an environment similar to the one he or she enjoyed in the womb.

Water Birth facility at Surya Hospital, Mumbai for Complete Care

Surya Child Care’s world class water birth facility is based on a mission to actively deliver holistic manage mentfor the expectant mother and child through the best medical, financial and emotional support that makes child birth and fostering a commendable experience.The hospital has built a city-wide reputation in Mumbai due to the presence of its superior health care for the last 3 decades. It is now the fastest growing Pediatric hospital in India, with the critical distinction of having all the important sub-specializations in one completely-contained hospital.Surya Child Care in Mumbai has established itself as a center of choice for intensive expertise and high-quality care.