How Early Can Baby Survive Outside the Womb
The baby daughter weighed less than a pound when she was born just 21 weeks into Courtney Stensrud'due south pregnancy. Infants that tiny and undeveloped aren't expected to survive outside the womb, merely her female parent insisted that she be resuscitated.
Lyla — who is now 4 — appears to accept fabricated medical history.
Her doctors believe the Texas daughter is the nearly premature surviving baby e'er reported. Her case means they tin no longer say death is certain for babies delivered at 21 weeks' gestation, "though it remains highly probable," wrote Dr. Kaashif Ahmad, a MEDNAX-affiliated neonatologist at the Pediatrix Medical Group of San Antonio, Texas, final year in the periodical Pediatrics.
"I feel blessed that we were given this niggling phenomenon baby," Stensrud told TODAY when Lyla's story beginning went public in 2017.
When TODAY caught up with her on Thanksgiving Eve 2018, she had a lot to be thankful for. Lyla is a little behind on speech, simply she's otherwise "doing really well" and doesn't take any medical issues or disabilities, her mom said. The girl will shortly return to preschool and recently attended a NICU reunion at Methodist Children's Hospital.
Stensrud has started a blog to tell her daughter's story and reach other families who may be going through a like state of affairs.
Doctors tin't predict Lyla'due south time to come, simply they take every reason to exist hopeful for her connected long-term skillful wellness, Ahmad noted.
"Lyla is a beautiful... wonderful little girl," he said. "Lyla not only fought and survived to make it dwelling, but is thriving today. Knowing her over the past iv years has been an extraordinary journey."
'I just absolutely idea she could survive'
The child'south fate seemed much grimmer in 2014.
Stensrud, at present 36, and Ahmad first met in the delivery room of a San Antonio infirmary minutes after Stensrud gave birth. The 14.5-ounce baby — who was lying on her tummy still attached by the umbilical cord — was due in November, but it was only July. "It was shocking to see a living, breathing person that modest," she recalled.
Stensrud went into early labor after experiencing premature rupture of membranes and chorioamnionitis, an infection of the placenta and the amniotic fluid. She had a few moments to enquiry whether a baby born that early could live and knew it wasn't possible.
"Simply when I was holding a live baby in my arms, I just absolutely thought she could survive. I felt information technology in my heart," Stensrud said.
When Ahmad found out the pregnancy was estimated to be just 21 weeks and four days along, he quickly counseled her about the babe's dire prospects. Infants delivered before 22 weeks' gestation are too premature to survive, he said. Their lungs are so underdeveloped that it's near impossible to evangelize oxygen into their bodies.
Even at 22 weeks, breathing tubes may not be small enough to fit into a preemie's airway and ventilators may non provide small enough breaths for their tiny lungs. The blood vessels in their brains are so fragile that they're prone to break and cause big bleeds into the brain, Ahmad said.
The possible consequences: cerebral palsy, difficulty walking or running, the loss of function or all of their vision and learning disabilities. They may face severe health issues for the rest of their lives.
Obstetric and pediatric societies recommend against trying to resuscitate such small infants, the Pediatrics paper explains. Such efforts "may be considered futile or non in the all-time interests of the child" considering it'due south extremely rare for babies built-in this premature to survive without "significant" neurologic consequences, the American Academy of Pediatrics notes.
Stensrud needed to make a fast decision about her girl's fate.
'They work miracles'
"Equally he was basically telling me in that location was zippo they could practice, I said, 'Will you try?'" Stensrud said.
"My answer was, 'If you would like u.s. to effort then I'm admittedly happy to attempt'… knowing that there were no guarantees," Ahmad recalled.
After doctors clamped the baby'due south umbilical cord, he placed her under an overhead warmer to heighten her body temperature and placed a breathing tube into her airway.
"From that signal, she gradually responded. She turned pink. Within a few minutes, she began to make efforts to breathe and then she began to move," he recalled.
"They work miracles," Stensrud said.
Lyla was whisked to the neonatal intensive intendance unit and spent about iv months in the hospital. She finally came home iii days earlier her original due date in November 2014.
Today, she's "she'south happy, full of energy and full of life" and keeps right upward with her v-year-old brother, Stensrud said.
She does not have cerebral palsy. Mild cases tin can exist starting time diagnosed at 3-5 years of age, only doctors don't have reason to believe Lyla volition take cerebral palsy subsequently, Ahmad added.
But people need to be very cautious about last from a single case that routinely resuscitating babies born in the 21st calendar week of gestation is the best approach, Ahmad warned. Don't assume one positive event will be the outcome for other infants, he noted.
"At this fourth dimension, resuscitating infants who are born in the 21st calendar week of gestation is not standard practice anywhere in the world. Even for those infants born in the 22nd calendar week of gestation, there continues to exist meaning disagreement regarding the all-time course of action due to the high mortality and substantial risks for long term disability," Ahmad said.
Still, Stensrud said she feels hopeful other babies in a similar situation will be given a chance at life, similar her girl was. And she wants other parents to know survival is possible. Telling Lyla'due south story and giving promise to other families has become Stensrud's passion.
"The reason I'm doing these interviews — it'south not for me, it'southward non for my girl. It's for that female parent in antepartum who is frantically searching online — that she volition have a little scrap of hope and faith that she tin have the aforementioned outcome," she said.
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Source: https://www.today.com/health/born-21-weeks-she-may-be-most-premature-surviving-baby-t118610
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