The triplets from Hong 'an, Huanggang were born prematurely at just 27 weeks, with an average birth weight of just 1 kilogram, and a total weight less than a full-term baby. After their birth, the local medical staff held the air bag to maintain their breathing, waiting for rescue, and Wuhan children's Hospital transfer team received the three "palm-sized babies" to Wuhan safely. The triplets and the temporary "moms and dads" of the Neonatal Internal Medicine Department who had experienced hundreds of battles overcame all the difficulties in the way, and smoothly pushed through, and the family took the eldest child in triplets home from the hospital on July 14. The premature triplets all have been discharged in a healthy state now.
The triplets, born at a gestational age of 27 weeks, weighed less than 3kg together.
On April 2 this year, Chen Xing (pseudonym), who was 27 weeks pregnant in Hong 'an County, gave birth to three premature babies in an emergency. The eldest was a boy with a birth weight of 1.1 kg, followed by two girls with birth weights of 0.92 kg and 0.9 kg, respectively, and all were ultra-premature and very low birth weight infants.
After the three babies were born, local medical staff couldn't help but worry about the three little babies, because the vital signs of the three infants were very weak due to prematurity, extremely low weight, immature development of multiple organs, disability of establishing spontaneous breathing, and hypoxia. The doctor quickly called Wuhan Children's Hospital, the alliance unit for help, and contacted referral. After confirming the information and making preparations, doctors Wang Qun and Yuan Wenhao, head nurse Huang Yanping, specialist nurses Zhu Fuli and He Li from the Neonatal Internal Medicine Department of Wuhan Children's Hospital set out from Wuhan in two groups at 10:30.
Chen Hongbo, the director of Neonatology Department of Hong 'an County Maternal and Child Healthcare Hospital and his colleagues quickly wrap the triplets in plastic wrap to keep them wet and warm in the "golden hour" after birth. Doctors and nurses took turns pinching the mask AMBUs to deliver oxygen to help them breathe and give them chance to survive.
Upon arrival at the local hospital, Dr. Yuan Wenhao saw that the three babies were only palm size, with the whole-body skin thin and tender, gelatinous and delicate, and the eldest brother had mild cyanosis. Premature infants were prone to progressive dyspnea within six hours of birth due to lung dysplasia. In order to ensure transfer safety as much as possible, the babies were intubated before transfer, so as to not only ensure the effectiveness of ventilation, but also help them establish the respiration channel.
Based on the successful experience in transferring nearly 2,000 neonates, the team was able to handle the three extremely premature babies in an orderly way. Personnel, equipment, medical support that may be needed on the way, and even all kinds of emergency plans were all perfected to give children the most reliable guarantee. After gently placing the three babies in the incubators, the neonatal ambulance returned. The medical staff closely monitored all vital signs of the babies with weak vitality and dealt with any unstable conditions in time, and even started to provide neuroprotection and multiple organ support for the very low birth weight infants on the way. Eventually, the three babies were safely transferred back to Wuhan and admitted to the Neonatal Intensive Care Unit (NICU).
Lungs weren't strong enough to support breathing, which was the "first hurdle" for the triplets.
The three little babies in the incubators breathed hard, with their chests sagging deeply with each breath. A common problem among premature infants occurred in all three babies: A lack of a substance that could make pulmonary alveoli open. After birth, their lungs were not strong enough to support breathing on their own, which was the "first hurdle" of breathing. Zeng Lingkong, chief physician of Neonatal Internal Medicine Department, Wuhan Children's Hospital said: "Breathing is like the first piece of domino. If it is stable, the domino behind it will not fall down easily."
After the three babies were admitted to the hospital, the doctors quickly used pulmonary surfactant to support the collapsed alveoli, so that they could breathe smoothly; and the IV therapy team of the department successfully placed umbilical venous catheter for the babies in time, ensuring the timely and effective infusion of various drugs into their bodies. Ten days later, peripherally inserted central catheters (PICC) were also placed to establish a life "channel" for the three babies, so that a variety of therapeutic drugs and nutrients could be continuously infused into their body, which not only reduced their pain, but also reduced the risk of infection.
Director Zeng Lingkong introduced: "Under normal circumstances, premature infants with immature nervous system perceive the filtered world outside in a warm, quiet and dark environment, and have their mature nerve fibers develop slowly, while the normal light and sound is like drum beating in the ear and searchlight shine on the eye for them, causing great harm to their neural development". Therefore, in order to help the three babies to feel like in utero, the medical staff put up a thick cotton cover outside the incubator to block all the light and simulate the "small dark room" environment of the uterus. The nurses took turns to guard the side of the incubator 24 hours a day, reduced the sound of speech and operation, and controlled the growing environment, so as to ensure the baby's deep sleep every day and promote the nervous system development.
After overcoming all the difficulties in the way, the triplets returned to the arms of their parents.
The rescue of premature infants is a continuous process, and it is necessary to observe the changes of infants' signs constantly. The triplets were only aged 27 weeks, so their internal organs were immature, and in addition to the "hurdles" in breathing, infection, and nutrition, they would also suffered from many premature complications, such as bronchial pulmonary dysplasia, intracranial hemorrhage, leukomalacia in preterm infants, necrotizing enterocolitis, and retinopathy, and any "hurdle" or complication would cause sequela and even endanger life. Experts made a detailed diagnosis & treatment plan for the three babies, and the Neonatal Internal Medicine Department also set up a special care team to monitor their conditions 24 hours a day.
During the treatment, neonatal respiratory distress syndrome in varying degree occurred in the three babies. Doctors provide assistance in the slowly transition from invasive ventilator to non-invasive ventilator until they could breathe on their own. In terms of feeding, from the micro-feeding of colostrum to the full gastrointestinal feeding, nurses patiently adjusted the feeding amount.
During the treatment at the Neonatal Internal Medicine Department for more than three months, the three babies and "battle-hardened" temporary "parents" overcame all difficulties and gave the manifestation of the most tenacious vitality. On June 21, the youngest sister with the best performance all the time was first discharged, followed by the elder brother and elder sister. The weight of the three babies reached 2.3 kg, 2.5 kg, 2.8 kg, respectively at discharge, all with flexible expression in eyes, and quick response to the parents' caress. Now, home care is required for the three babies, during which parents should establish an emotional connection with the babies.
Director Zeng Lingkong said: "Saving very low birth weight infants is just our primary goal, and we will spare no efforts to make them have well developed and responsive nervous system, good physical nutrition development, and no sequelae, so as to catch up with normal full-term infants in all aspects, and become the "pillars of society" in the further."