A baby born at 24 weeks of gestation, weighing just 650 grams, has survived after spending 78 days in the neonatal intensive care unit (NICU) at Yashoda Medicity in Noida. The infant was from an IVF twin pregnancy, but the co-twin died in the womb at 22 weeks. In the NICU, doctors treated the infant for multiple complications associated with extreme premature birth.
Emergency C-Section and Initial Challenges
The mother underwent an emergency C-section following placental abruption, a potentially life-threatening condition in which the placenta separates from the uterus before delivery. “The baby was delivered at only 24 weeks and weighed 650 grams. At this stage, almost every organ system is immature and survival itself becomes a challenge,” said Dr Neha Agrawal, consultant, Pediatrics & Neonatology at Yashoda Medicity.
Doctors said that while the newborn cried immediately after birth, severe respiratory distress developed soon afterwards. The baby was shifted to the level 3 NICU, where doctors administered three doses of surfactant — a substance that helps keep the lungs open — and provided ventilator support for seven days. The infant was later transitioned to non-invasive breathing support and gradually weaned off oxygen.
Feeding Difficulties and Nutritional Support
“Feeding also posed a challenge. Due to feed intolerance, doctors initially relied on total parenteral nutrition (TPN), where nutrients are delivered directly into the bloodstream. Full milk feeds could be established only by the 18th day of life,” Agrawal said.
Sepsis and Infection Management
The infant’s condition became more complicated when sepsis, a serious bloodstream infection, developed. After two weeks of intravenous antibiotics, the baby subsequently contracted fungal sepsis, requiring intensive antifungal treatment. “Extremely premature babies have underdeveloped immunity and are highly vulnerable to life-threatening infections. Managing sepsis while supporting growth is one of the most difficult aspects of neonatal care,” a doctor said.
Neurological and Eye Health
Despite the complications, serial brain scans showed no evidence of major neurological injury. Eye examinations initially remained normal, but the baby later developed retinopathy of prematurity (ROP), an eye disorder seen in very premature infants. Doctors performed laser therapy, leading to successful regression of the disease.
Discharge and Recovery
After nearly three months in the NICU, the baby was discharged weighing 1.6 kg, breathing independently and feeding well through breastfeeding and spoon feeds. The case highlights both the risks associated with extreme prematurity and the advances in neonatal care that are helping increasingly smaller and younger babies survive, doctors said.
