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Born too soon: IHK discharges twins delivered at 25 weeks.

Monday 19th July 2021

On 16th May 2021 Asha Mary Simon 30, was 25 weeks pregnant, expecting to go through a normal pregnancy, little did she know that she would give birth sooner than expected. On the morning of 17th May after life threatening events, she was able to deliver four babies following an emergency C-section procedure at IHK. Asha delivered 3 girls and a boy having had an IVF procedure because she had been trying to conceive for 8 years without success.

A handful of children born at 25 weeks barely make it through their first 24 hours in Uganda. At 25 weeks, the baby normally weighs about 660 grams, the brain and the nervous system may not be fully developed. These neonates are prone to infections and breathing difficulties because their lungs are not fully developed to produce surfactant and so is their gut which is not fully developed to enable digestion. Neonates at 25 weeks often experience anaemia and jaundice caused by immature bone marrow and liver, respectively. They would battle to survive due to immature vital organs. Most of them die.

The chances of survival for a neonate delivered at that age are very minimal and mostly depend on the environment and hospital where they are delivered. They require functional neonatal facilities and specially trained neonatal nurses and a paediatrician with specialist training in management of babies born prematurely also known as a neonatologist. Fortunately, these children were delivered at International Hospital Kampala, a hospital with these facilities and staff available to support these delicate lives. They were born weighing 720grams to 760 grams which was slightly above the expected weight according to UK standards.

Asha lost the last 2 babies after 9 and 25 days because of immature organs that could not support their lives even with technological support. She remained with the first 2 girls who have battled through growing from 25 weeks to 34 weeks and gaining up to 1.1kg more than their birth weight. At the time of discharge, the babies weighed 1.8Kgs and had a normal head circumference among other key growth indicators.

Dr. Shiba K. Nahurira, the head of Paediatrics at IHK was thankful to the doctors, midwives, Intensive Care Unit and Neonatal Care Unit staff who received the babies and supported them through the tough days for their dedication and commitment towards the survival of these children. She thanked Mary Asha and her family for remaining strong and not giving up even when there was little hope for survival. Dr. Shiba thanked Dr. Victoria Nakibuuka the consultant Neonatologist for guiding the team through the process. Further, a team of nurses and midwives who offered to express their milk which was used to feed the babies was recognised for their selflessness.

Dr. Victoria Nakibuuka congratulated Asha upon discharge and thanked her for her support and the IHK team for taking care of these neonates with dedication and love. She asked Asha to be an advocate for Kangaroo Mothercare which she did faithfully with guidance from the medical team to see these babies through. Dr. Dennis Muyaaka the Paediatrician who received these babies at birth also thanked Asha for her commitment and patience without which these two would not have survived. The hospital handed over a few items to the mother to celebrate this milestone and indicate their support to the family.

Asha Mary Simon the mother was very grateful to God and to IHK for not sending her away like other hospitals she had been to when she needed emergency services. She was very thankful to the Doctors and nurses for their guidance and support. She indicated that it was her first time to get treatment at IHK and that she had been impressed by the level of care and love towards patients that the team had from the day she was admitted.

IHK is one of very few hospitals in Uganda with a fully functional Neonatal Intensive Care unit and a team of trained and experienced Neonatal nurses. Every year in November IHK joins the world to celebrate and raise awareness about children born prematurely. The hospital is committed to support expectant mothers who may experience challenges during pregnancy including delivering their children prematurely.

Article by Peter Mulindwa, Photography by Timothy Nkwasibwe

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