When 34-year-old Bandra-based businessman Vishal (surname withheld on request) heard his wife had delivered in 22 weeks of pregnancy, he expected to see an “alien-looking” pre-term baby, not sure how developed his physical features would be. Born weighing 610 gram and measuring 32 cm, Nirvaan remained in neonatal intensive care unit for 132 days since his birth on May 12, surviving internal brain bleed, hernia surgery, eye treatment and three punctures near his lung.
This is one of the youngest pre-term babies to survive in India. In 2011, a 24-week newborn boy, Surya, had survived in Mumbai followed by another 23-week baby, Sakshi, who also survived. In the latest case, a team of 14 doctors and over 50 nurses were posted to handle the baby. Nirvaan now weighs 3.72 kg and is slated to get discharged in two days from the Surya hospital in Santacruz (West).
“It was 11 in the morning when I was undergoing scans and had lower back pain. The labour started immediately and by 2.14 pm, the baby was delivered. I did not even get time to prepare,” says Retika, 34, who works as a manager in an aviation company. She suffered from urinary tract infection when she went into labour pain. According to gynaecologist Sejal Desai, she delivered within minutes of reaching the hospital in Santacruz, from Bandra.
Nirvaan was placed on high frequency ventilator support in the delivery room itself. Doctors at Surya hospital said that survival chances of such pre-term births are 15-20 per cent, of which half who do survive develop neurological problems. “When I saw our baby in an incubator, the emotional bond was formed. We discussed with our family and decided to try whatever was medically available to save him,” Vishal says. “In the first six weeks, it was difficult to say whether he would survive. After his third surgery where air around his lung was punctured out, I asked my wife whether we should let it go,” the father adds.
Nirvaan had underdeveloped brain and lungs, while his other organs were too premature to function on their own. He was put on respiratory support for 12 weeks. The under-developed brain faces risk of internal bleeding. Nirvaan suffered from a brain bleed once but recovered.
“Such babies may suffer from neurological problems. We conducted five ultrasounds to ensure there was no anomaly,” neonatologist Dr Hari Balasubramanian said, adding, “sometimes it was difficult to clearly spot the baby in the bundle of tubes, gadgets, incubator and ventilator support he was in.”
Nirvaan required a hernia operation when he was 3.5 months old. Another laser surgery to treat damage in the retina, retinopathy, was conducted along with multiple blood transfusions. According to Dr Bhupendra Avasthi, director of Surya hospital, survival chances were high once the baby weighed 1 kg.
Two weeks ago, the 4.5-month-old baby was weaned off ventilator support and put on breast feed. “It’s been very difficult, specially for our baby to survive all this,” Retika says. While government hospitals do not have the sophistication to handle such cases, such as portable x-rays, CT-scans, constant nursing manpower, and neonatologists, private treatment comes at huge costs. A single day’s ICU charge was Rs 10,000, taking the cost of just intensive support for 132 days to Rs 13.2 lakh. Cost of other variables such as surgeries, tests and medications can escalate the bill beyond Rs 20 lakh.
In government hospitals, doctors have been able to help babies weighing as low as 700 grams survive after pre-term delivery post 30 weeks. Across Maharashtra, there are 36 newborn care units to support such neonatals, but no neonatologist to treat critically ill newborns.