Shivanya and Gianna
When my daughter was born, she was smaller than the palm of my hand. When I saw my daughter for the first time her eyes were wide open. It gave me hope that she would be alive, says Shivanya’s mother Ujjwala.
Doctors said Gianna would not survive. But she is four years old now. “I am bringing her up like a normal child as per the advice of the doctors,” said Gianna’s mother Dinel.
This is the story of two babies born prematurely from two different wombs. Their survival was considered a miracle.
Ujjwala Pawar, who lives in Mumbai, gave birth to Shivanya in the 22nd week of her pregnancy in May last year.
Ujjwala Pawar had a bicornuate uterus. The baby could not fully develop in her womb. Because of that he started having pain very soon,” said doctor Sachin Shah, speaking to the BBC from Mumbai. Ujjwala already has a son. He had no problems during the delivery. But problems started when she became pregnant for the second time i.e. when Shivanya came in her womb.
Ujjwala went into labor before the completion of nine months as the baby did not develop fully in the womb.
Bicornuate uterus is in simple words, the uterus divides into two cavities. This is a rare one. If a woman has a bicornuate uterus many times she will not be able to complete the nine month pregnancy. Either she miscarries or such women go into premature labor and give birth.
If a woman gives birth before 28 weeks, such a condition is known as premature or early delivery.
Ujjwala was admitted to the hospital and an ultrasound revealed that the baby weighed around 500 grams, said Sachin Shah, a doctor associated with the neonatal and pediatric intensive care unit at Surya Hospital in Pune.
A doctor who treats newborn babies and problems that arise after birth is known as neonatologist.
Sasikant Pawar and Ujjwala with their daughter Shivanya
Two inspiring stories
At the time of delivery, the weight of the baby girl was only 400 grams. She was smaller than the size of the palm of her hand. The parents wanted to somehow save the child.
“When I saw my daughter, only her face was visible. Her eyes were open. That gave me hope that she would be alive. I didn’t let any negative feeling enter my heart. This positive attitude towards life has helped us,” says Shivanya’s mother Ujjwala.
“When I was allowed to visit Shivanya after she was born, her little pinky finger touched me. Words cannot describe what I felt then. It gave me a feeling that my daughter would be safe,” said father Sasikanth Pawar.
Gianna was born at 22 weeks in Surat, Gujarat, four years ago. Gianna weighed 492 grams at birth.
Gianna was born in October 2018.
When Deenal came to me, her water bag, or sac, was leaking, Dr Ashish Mehta, director and chief neonatologist at the Ahmedabad-based Urban Newborn Care Centre, told the BBC.
Dinel was carrying twins. The pack of one of them was leaking.
image source, DR ASHISH MEHRA
“Deenal was in her 21st week of pregnancy. It is very difficult for twins to survive in such a situation. Obstetricians also threw up their hands as there was no case in medical history of any baby surviving after delivery at 21 weeks,” he informed.
“I also did a lot of research. I expressed doubts about the possibility of the baby surviving after such a delivery,” said Ashish Mehta.
Deenal was admitted to the hospital and meanwhile completed her 22nd week. The family wanted Dinal to give birth to the child.
However, if the delivery takes place before the 24th week, the chances of the baby developing disorders increase, doctors said.
“We told the doctors to somehow save our baby. They were able to save only one child. A lot of courage and composure is needed in such a situation,” noted Dinel. In both Mumbai and Surat cases, the babies were born before the 24th week.
What are the possible risks to such children?
Babies born prematurely have a five to ten percent chance of survival, say doctors Sachin Shah and Ashish Mehta.
Brain sonography in such children increases the risk of organ failure in the future if hemorrhage is detected.
During the three-fourth week after birth, the baby is assessed for possible complications.
If the eyes are not developed there is a risk of losing sight. There is also a risk of hearing loss.
In such children the organs are not fully developed. Hence there will be no immunity.
Risk of sepsis
Infection may occur
There is also a risk of kidney failure.
Whenever the delivery takes place in the 24th week or earlier, the baby does not cry and the body becomes cool. Both doctors say this is called hypothermia.
image source, DINAL
Gianna, now four years old, with her mother
Hypothermia occurs when the body does not have enough fat to match its weight. Those children are weak because their bodies are not fully developed.
In such a situation the baby is placed in an incubator. The temperature is maintained so that the baby’s body is warm.
“Children’s organs such as lungs, kidneys, intestines, heart are not fully developed. When they are unable to breathe on their own, a mask called CPAP is applied directly to the lungs,” said Dr. Ashish Mehta.
“The baby cannot drink milk orally. So protein, fat, carbohydrates, vitamins and minerals are given to the baby through the umbilical catheter. This way all the nutrients are available to the baby,” he explained.
“A Rhyles tube is inserted from the mouth to the stomach and milk is fed. And we monitor how the baby is doing. We watch for bloating and vomiting. These two processes happen at the same time.” He said.
“When the baby’s growth starts to show and the doctor is satisfied that the baby is able to digest milk, the baby’s umbilical catheter is removed,” he noted.
After this work is done to increase the weight of the child. In such a situation the baby is kept in an incubator for 11-12 weeks. After assessing the baby’s growth at 34 weeks, it is seen whether the baby is able to suck the mother’s milk on its own or not. If able to do so the child is discharged.
A routine check-up is done on the baby at three, six and eight months.
How are the children?
image source, SHASHIKANT PAWAR
Shivanya Pawar is currently growing slowly
Gianna recently celebrated her fourth birthday.
” She kicks her arms and legs. Screams and laughs. The family is very happy to see her growing up,” Shivanya’s father Sashikant said.
“I can’t describe how scared I spent those nine months when I got pregnant for the second time after Gianna. Doctors have said that Gianna should be brought up like a normal child. That’s what we do. Gianna is now a big sister. She takes good care of her younger sister. I just want to say that you should never lose heart,” said Gianna’s mother Dinal.
BBC Tamil on Social Media: