The baby's mother had a history of premature birth 7 years prior. This pregnancy was achieved through in vitro fertilization (IVF). At 22 weeks gestation, she experienced membrane rupture and went into labor. Doctors admitted her to the hospital and administered medication to reduce contractions and performed a cervical cerclage to prolong the pregnancy.
The membrane rupture recurred at 25 weeks gestation. Dr. Nguyen Thu Van, Deputy Head of the Neonatal Department at Tam Anh General Hospital Hanoi, and her team provided emergency prophylactic treatment with antibiotics and corticosteroids to mature the baby's lungs, helping prevent infection. The pregnant woman then showed signs of umbilical cord prolapse, necessitating an emergency C-section.
A 25-week fetus is considered extremely premature, with underdeveloped organs such as the lungs, brain, digestive system, and immune system. The baby could not breathe independently at birth because her lungs had not produced enough surfactant, her blood vessels and nervous system were fragile, and her intestines were not yet fully developed. The medical team prepared resuscitation equipment and resources, including a mechanical ventilator, specialized monitors, resuscitation medications, and adjusted the operating room temperature to ensure the best conditions for the baby's arrival.
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The baby was cared for in an incubator. *Photo: Tam Anh General Hospital*
The baby was born without reflexes, had stopped breathing, and weighed only 700 g. Doctors immediately performed intensive resuscitation on the mother's abdomen, using late cord clamping to allow the baby to receive blood from the placenta. Afterward, the baby was quickly transferred to the Neonatal Department, where her body temperature was stabilized, mechanical ventilation was initiated, antibiotics were started, and intravenous nutrition was administered within the first hour after birth.
On the third day, the baby developed chest retraction and feeding intolerance. An echocardiogram revealed a large patent ductus arteriosus (a type of congenital heart disease). Doctors prescribed treatment to close the patent ductus arteriosus while simultaneously treating enteritis with antibiotics and continuing intravenous nutrition. The baby's respiratory condition improved by the fifth day, allowing a transition to non-invasive respiratory support (CPAP). In the subsequent weeks, the baby received minimal oral feeding.
Premature infants, especially those born between 23 and 32 weeks, lack sufficient muscle tone, have very soft joints, and possess delicate lungs and nervous systems. Incorrect positioning can affect a baby's respiration and lead to head and limb deformities. Therefore, even while on mechanical ventilation, the baby received care in a standard position. Additionally, doctors incorporated Kangaroo Mother Care (skin-to-skin contact between mother and baby) to promote optimal recovery.
After more than two months of respiratory support and intensive treatment, the baby transitioned to oxygen therapy, gained weight well, and began practicing feeding. She was discharged from the hospital when she could breathe and feed independently, weighing 3 kg, and in stable health. A follow-up visit two months later showed the baby continued to gain weight according to the growth chart for premature infants. Neurological, motor, respiratory, and cardiovascular examinations detected no abnormalities. The baby received vaccinations with a schedule adjusted for premature infants.
To prevent premature birth and reduce the risk of complications, pregnant women require close prenatal monitoring, a scientific nutrition regimen, and adequate rest.
