Extreme Preterm (28 Weeks) Extreme Low Birth Weight (ELBW) / Intra Uterine Growth Restriction (IUGR) Respiratory Distress Syndrome (RDS) Received Surfactant & Invasive Ventilatory Support initially and currently on Non-Invasive Ventilatory support Severe Sepsis / Shock / Coagulopathy / Thrombocytopenia Neonatal JaundiceCourse:
Baby of Vijaya Lakshmi is a 28 weeks premature baby weighing 985 grams, born to a 32-year-old mother after 7 years of marital life & 2 previous abortions. During this pregnancy she had severe pregnancy induced hypertension (PIH) on multiple antihypertensive medication. Antenatal scans also revealed a significant fetal growth restriction.
The Baby was delivered early (Due to Fetal compromise) at 28 weeks of gestation by emergency LSCS on 7 th October 2019 at 3:45 pm. The weight was 985 gm at birth and he was noticed to have poor respiratory efforts, so was intubated / resuscitated / ventilated and shifted to Little Stars Children’s Hospital.
Baby had severe Respiratory Distress Syndrome (RDS), received 1 dose of surfactant and extubated to NIV-PC. On Day 1 of life, baby had poor perfusion with metabolic acidosis, needing inotropic support. 2D Echo revealed severe Pulmonary Artery Hypertension (PAH). The baby also had severe sepsis (CRP-69) with a low platelet count and coagulopathy for which antibiotics were upgraded, received SDP x 2 transfusions and 1 FFP transfusion.
On Day 2 of life, baby had high Jaundice TSB (17.5) with no major incompatibilities & received intensive phototherapy. Currently the baby is tolerating oro-gastric feeds (Expressed Breast Milk) and stable on non-invasive ventilatory support & Intensive Care management. Baby needs at least 8 weeks of NICU stay until a corrected gestational age of 36 weeks.