KOLKATA, May 15 -- A 27-year-old lady, who was 33 weeks pregnant (full-term pregnancy is between 37 and 42 weeks), gave birth to preterm twins with low birth weight, Respiratory Distress Syndrome (RDS) and neonatal jaundice.

The lady with IVF pregnancy was admitted to Ruby General Hospital with complaints of shortness of breath. She was admitted under (Prof) Dr Sudhir Adhikary, Consultant Obstetrics & Gynaecology.

She was a known case of hypothyroidism, gestational hypertension, preeclampsia (high blood pressure and signs of organ damage, typically occurring after 20 weeks of pregnancy), cardiomyopathy and acute decompensated heart failure as well as pedal edema. The lady was initially on BiPAP followed by High-Flow Nasal Oxygen (HFNO).

After discussion with family about the risk factors involved and with their written consent, she was posted for emergency caesarean section. She delivered live preterm twins.

The twins were under the care of Dr Parichaya Bera. The birth weight of twin 1 was 1945 grams and twin 2 was 1410 grams, whereas the normal birth weight of a baby generally falls between 2.5 kg and 4.5 kg.

Twin 1 baby cried spontaneously immediately after birth but was lethargic and had a poor cry while twin 2 did not cry and needed bag and mask ventilation. Both twins were shifted to the NICU and put on non-invasive ventilation.

After a couple of hours, twin 1 baby developed respiratory distress and grunting which did not resolve with non-invasive ventilation, so she was put on an invasive mechanical ventilator and surfactant was given for lung maturity.

Peripherally Inserted Central Catheter (PICC) lines were done for both the babies and started on antibiotics, nutrition and I.V. fluids. Phototherapy had been started for both babies due to Hyperbilirubinemia (A condition in which there is too much bilirubin in the blood, causing yellow discolouration of the eyes and skin called jaundice).

Gradually, both babies were extubated and put on Nasal Cannula Oxygen. Initially, orogastric tube feeding was given to both babies and then oral feeding was gradually established. Twin 1 went home after around two weeks of hospital stay and twin 2 joined her after three weeks.

Published by HT Digital Content Services with permission from Millennium Post.