Neonatal intensive care unit works to save the tiniest patients

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To the delight of Lizet and Francisco Robles, ultrasound showed their third child would be a girl.

After giving birth to two sons, the family hopes to be reunited with their daughter. It seems that their dream will come true.

“We were very happy, and everything went well,” said Lizet, who was working as a banker at the time in the Tri-Cities area of ​​Washington state.

Then in 21 weeks, the situation changed.

“After a look, things started to feel good,” she recalls.

A local OB-GYN survey a week or two later revealed that Lizet had already fallen by 2 centimeters. Finally he told the couple to hurry to the University of Washington Medical Center-Montlake to enter. Doctors planned to do some surgery to cover her cervix, but eventually they proved it was too dangerous.

IN cesarean section at only 22 weeks pregnant not in question. Lizet had to give birth in the vagina. She spent most of the day in labor, and then, suddenly, her baby was born. Lizet remembers little of the time. But she remembers begging the hospital doctors Department of Pediatrics to save her daughter. At 11:30 pm on July 19, 2021, Savannah Robles was born at 22 weeks. She weighed only 1.2 kilograms.

“They told me that if this birth had taken place before January (2021), she would have died, they would not have had the technology to save her,” she said.

Most hospitals do not have the equipment to care for premature babies under 23 weeks of gestation. In fact, UWMC-Montlake began doing so six months before the birth of Savannah.

Credit: UW Medicine

“We have reached out to institutions that do this in the United States and we have met with their staff to learn how to continue to develop these children and give them the opportunity,” said Dr. Thomas Strandjord, a physiologist at UWMC- Montlake neonatal neonatal intensive. care department. He took care of Savannah during her early days.

Babies under 23 weeks of age face challenges from some premature babies. Their undeveloped lungs cause breathing problems, bruising, and sometimes chronic lung damage requires long-term support along with. extra oxygen. Their skin is weak, still not good at protecting against infections or keeping their bodies warm. They are also more prone to intestinal perforation, which occurs in Savannah, Strandjord said.

“We have created a team of highly qualified neonatologists, paramedics, nurses and others who are dedicated to taking care of these pilots. unborn babies“he said about the extreme initial UWMC-Montlake program.

Caring for these infants requires regular monitoring; small airways and ventilators that are easier on the lungs; special regulations for the supply of nutrients and fluids; and incubators to retain heat, prevent water loss and maintain their ambient temperature.

At UW Medicine, the life expectancy of these small patients is about 50% – but 15 months ago, hospital NICU doctors could not offer any hope to a newborn in Savannah. “We’re just going to take care of them and let the parents hold the baby before they leave,” Strandjord said.

Currently, the UWMC-Montlake NICU is the only hub in the Northwest to provide this care, he said. Since the program began, NICU has seen about one or two of these babies, who are between 22 and 24 weeks pregnant, one month, he said. At the end of last month, however, the NICU had six.

Savannah went home in January 2022 on extra oxygen, which she still needed, although she was slowly being weaned as her lungs increased. Strandjord thinks she will never need him again. Right now, Savannah is 9 months old (or exactly 4 months if you count ahead of the expected date in winter), and weighs in at 16 pounds 8.

As the family approaches Mother’s first day with Savannah, Lizet Robles stands in tears.

“I am very grateful, to my family and to her, and to the staff of NICU. She is grateful to them that she is here,” Lizet said.

“Savannah is showing what is possible,” Strandjord said. “It’s good we can offer this option. Until recently we would say no hope, but now there is some hope. It is still a choice, it is still a challenge, but we give parents everything they need to decide advice.”

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