(12PressRelease.com) 17th February 2011; Pune - A little girl who's believed to be the smallest surviving baby in India has been sent home from the hospital, after 4 months of care in the neonatal intensive care unit at ONP Tulip, a worldclass women & childcare hospital in Pune. The baby, not yet named Pawar was born on 2nd October weighing only 495 gms. That's about the size of a small cabbage. She was recently discharged from ONP Tulip and currently weighs 2.4 kgs.
This was Shaila Pawar‘s 12th pregnancy - all the previous 11 pregnancies being unsuccessful, with 8 abortions and 3 intra-uterine deaths. For the 36 year old woman, who was married since 20 year, this 12th time was full of hope for her and her family, as she completed six months of pregnancy.
Dr.Sanjeev and Dr. Smita Dole, a Medical practitioner couple from Narayangaon was managing this pregnancy. Dr. Dole identified that Shaila would get sudden abrupt elevation in her blood pressure during pregnancy. This entity is called ´pregnancy induced hypertension‘, commonly referred to as PIH. To give her and the baby the best care, Dr. Dole referred her to ONP Tulip, which has the best in medical technology as well as infrastructure - a state-of-the-art hospital, where medical expertise, advanced technology, infrastructure, comfort & luxury collaborate to provide the best of facilities not only for the mother and child, but a great facility for doctors to work in gynaecology, obstetrics, pediatrics and neonatology all under one roof.
“When Shaila Pawar first came to ONP, she was 6 months pregnant and showed some early signs of PIH. She was put under the care of Dr. Avinash Phadnis, Director of Obstetrics and Gynecology at ONP Tulip. She was started on anti-hypertensives to control the BP was advised to follow up with Dr.Dole for BP monitoring in view of the long distance.†explains Dr. Neena Sathe, Senior Obstetrician, ONP Tulip.
Later Mrs. Pawar had sudden elevation in blood pressure at home, and she was taken to Dr. Dole‘s Hospital at Narayangaon. Dr.Dole identified the seriousness of the situation and immediately brought Shaila to ONP Hospital by his hospital ambulance. “This transfer of mother in anticipation of need of neonatal intensive care, rather than transferring the baby after delivery was extremely important in this case. This is called ´in-utero transfer‘,†says Dr.Sucheta Parte, Consultant Obstetrician at ONP Tulip.
When Mrs. Pawar arrived at ONP her blood pressure was very high and she was already showing early signs of impaired brain and visual function. Dr. Phadnis took a decision to take her for emergency caesarian section. Neonatology team led by renowned Neonatologist and In-charge of Neonatal ICU at ONP Tulip, Dr.Tushar B. Parikh was called in to attend to this delivery. Specialized baby care starting from the time of birth is extremely important and is the main determinant of survival in these tiny babies.
´â€˜Baby of Shaila Pawar was born premature just at 27 weeks of pregnancy (Normal pregnancy duration 40 weeks) and weighing just 495 grams at birth on Gandhi Jayanti, 2nd October 2010. The baby required artificial breathing support to regularize her breathing and then she was quickly transferred to neonatal ICU‘‘, says Dr.Tushar Parikh , Senior Consultant and In-charge of Newborn ICU at ONP Tulip. “To salvage baby of this size was challenging. There is no reported survival of a baby weighing this small in India. Last reported smallest survival was a baby weighing 540grams. I have successfully managed babies smaller than this one, but not in India†he adds.
´Babies born this small have extremely poor function of all body organs which include lungs, heart, brain, kidneys, intestine, skin, adrenals etc. and all of them need support for survival of the child. Here comes the skill of a dedicated Neonatologist to identify and prevent or correct these problems, as margin of error in these tiny babies is close to none. Problems related to any one system can singularly kill the baby and is the commonest outcome in these cases. †said Dr. Amita Phadnis, Director of ONP Tulip Hospital and Department of Pediatrics and Neonatology.
The baby was handled and looked after in the Neonatal ICU with precision care. She was struggling to breathe and was gasping for oxygen at birth. She was immediately put on advanced respiratory support, the bubble CPAP system to support her breathing, and received the most advanced baby care in the form of Giraffe(TM) Omnibed incubator baby care system.
“Ironically ONP Tulip has the only Giraffe incubator of this city!. The Giraffe(TM) Omnibed is used worldwide, which offers that extra care needed for very low birth weight babies (with birth weight less than 1 kg). Giraffe is a highly sophisticated incubator plus warmer which gives very precise control over temperature and humidity. Giraffe has a host of other features which allow easy handling of very small babies. We are very happy and proud to have invested in the best infrastructure, equipment and manpower to give superior medical care in this city. It is no more necessary to travel thousands of miles to get best medical care anymoreâ€, beams Dr. Amita Phadnis
“These extremely small babies have special needs. They cannot be fed adequately due to immaturity of their gastro-intestinal system. We had to start the baby on Total parenteral Nutrition, which basically means giving all the essential nutrients such as amino acids, lipids, carbohydrates, minerals, multivitamins and trace elements directly into blood circulation. This procedure requires special, expertise and facilities, which we routinely do at ONP Neonatal ICU. The baby also required special venous access point as their veins do not tolerate these medicines. Such baby quickly looses all body water through their fragile parchment like skin by evaporation or they may drain all body water through their immature kidneys. These are special problems one has to anticipate and be prepared when you are managing a baby this small. A special long catheter made up of silastic material was skillfully inserted in baby‘s tiny vein. This catheter lasted 10 days, so that we could minimize cannulation procedures for those 10 days. We had to perform several functional echocardiograhies on baby‘s heart to assess and modulate heart function. Baby required respiratory support on and off for a period of about 1 month and later required supplemental oxygen for another 15 days. The baby stayed in the NICU for almost 90 days and when discharged home her weight was close to 1400 grams. By far the progress and clinical course in the NICU was very satisfactory for a baby of her weight and gestational age.â€, said Dr. Tushar Parikh
“These tiny babies are so fragile that they develop severe complications such as fractures if not handled properly. NICU nurses at ONP is extremely competent and trained to take care of such babies. They take their care of the baby like foster mothers till the baby goes home. These tiny babies have poor tone and they are at risk of development of postural deformities which are efficiently prevented by use of ´â€˜Early intervention and stimulation program†which we routinely offer to these babies at ONP Tulipâ€, says Dr.Manish Dadape, Associate consultant in Pediatrics and Neonatology.
“Later when baby was stable we started the baby on Kangaroo Mother Care (KMC). KMC helped the baby to gain weight faster and it also helped baby for prevention of infection and temperature regulation. This also helps mothers to get over their fears of handling these tiny premature babies.†Says the head nurse of NICU, Sister Reeja.
“We could have reported this case much earlier, but we wanted to ensure that the baby continues to grow normally and remains healthy after discharge. Now the baby is 4 months old and her weight is 2.4 kg. “, says Dr. Tushar Parikh.
“Our search on Internet, Medical journals and personal communication with neonatologists in different cities in India, indicate that this is the smallest birth weight survival†says Dr.Tushar Parikh
“It is the expertise of the leader of the NICU team, Dr.Tushar Parikh, which has given this phenomenal result and the ONP Tulip is now routinely having a > 90 to 95% survival for very low birth weight babies†says Dr.Amita Phadnis.
“I am glad that our dream of making ONP Tulip as a one point destination for all women and child problems under one roof has turned into a reality. We have invested in the best infrastructure, best equipment and best manpower, which is showing the desired results now. It was a team effort which was well orchestrated and executed by us resulting in excellent medical care to Shaila and her baby. And we wish all the best and good luck to the family‘, sums up Dr. Amita Phadnis.
ONP Tulip is undoubtedly the destination for comprehensive newborn care in all aspects, not just for premature and sick babies, but for healthy and bonny babies too!
For more details please contact :
ONP Tulip Hospital on 30206600 or [email protected]