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Labour of love: The 670 gram baby

ALEX SCOTT
Last updated 05:00 16/02/2013
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TINY DOT: Alex Scott's daughter arrived at 24 weeks.

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I was 23 weeks pregnant and went to see my midwife because of some concerns about the baby. The midwife listened to the baby's heart beat and said that she thought it was OK, but decided to send me for an ultrasound just to be safe.

I walked over to the Radiology Department and the ultrasound showed the baby moving fine, but she said she wanted to do an internal scan just in case.

The internal scan showed that I was already three centimetres dilated. I was laid on a gurney and wheeled over to the maternity ward. The midwife told me that from the look of the scans, the baby was on the way. She said that if she was born that day, at 23 weeks gestation, she wouldn't survive.

They called Westpac helicopter and within an hour I was in the delivery room at the hospital. A team of doctors came to see me. They said that if the baby was born today they would not revive her because she would be so premature the odds of her survival were basically nil.

I had another internal scan done and found I was fully dilated. There was talk among the doctors about stitching closed my cervix but that may cause even more damage to the baby so they decided not to.

The only thing to do was put me on full bed rest and hope that my waters did not break. So for the next ten days, I lay on my back and prayed that she stayed inside me.

When I was admitted to hospital, there was a 15 percent chance of survival for the baby, and we knew that every day I lay on that bed her chances of survival increased by three per cent. Every morning I would work out what survival percentage the baby had that day. The doctors wanted me to aim for giving birth at minimum at 28 weeks gestation, but at 24 weeks and four days my waters broke.

I was rushed to the delivery room. After four hours my contractions were very weak and the baby's heat rate was getting weaker. They knew they needed to do something. The doctor came to see me and said that they were going to give me drugs to speed up the labour; otherwise they would have to do an emergency caesarean.

Three hours later my contractions were very strong but suddenly the doctors couldn't find the baby's heart beat. The room was all of a sudden filled with six doctors and nurses telling me to push. One push later and our little miracle was born, weighing one pound, seven and a half ounces (670 grams).

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Straight away she was taken from me to the other side of the room where two doctors revived her and tried to get the breathing tube down her throat. The first attempt was unsuccessful but on the second attempt, after 11 minutes, they finally got the breathing tube in.

I got to give her a quick kiss before they rushed her away to the Neo Natal Intensive Care Unit. It was another two hours before I got to see her again.

My first impression of her was that she was this tiny, hairy, purple, beautiful dot. We were allowed to put our hands in the incubator and touch her, and she fit right in to the palm of my hand. The doctors explained we had to be careful with her because she was so fragile. Every time we touched her, her oxygen stats and heart rate would go down. By this time it was midnight and it was time to say goodnight.

I couldn't sleep that night; I was so excited about going to see her in the morning. The thought didn't even cross my mind that she was seriously sick and might not even make it through the night.

The next three days went well. She was put under a jaundice light on days one to four to clear her jaundice. Days one to fifteen she was on insulin because she was hyperglycaemic and classed as a 'temporary diabetic'.

On day three she was taken off the ventilator and put onto 'CPAP' (continuous positive air pressure) which is a mask fitted over her face to help her with breathing, but is less aggressive than the ventilator. This lasted until day 11 but she had bad apnoea (stopped breathing) and wasn't maintaining high enough oxygen levels so she was put back on the ventilator. We were very upset because the doctors had explained you only have two chances to get a baby off the ventilator. We'd just lost the first chance.

A scan of her heart showed that her Patent Ductus Arterious (PDA), a heart valve that is supposed to shut minutes after birth, didn't close. She was given doses of indomethacin on days 5, 6 and 7 and the valve closed, however it reopened on day 12. More doses of this medication caused acute renal failure and she had a catheter inserted. The decision was made to surgically close the valve at day 18.

The surgery lasted two hours, and she did great. When we went in to the room to see her afterwards she had a four centimetre long scar under her arm. The surgeon explained he had to enter through her ribs, push her lung out of the way just to get to the heart valve. The next day the catheter was taken out.

Scans of her brain and lungs came next. The brain scans showed that she had a grade two brain haemorrhage during birth and that this would need to be monitored to make sure the brain didn't bleed anymore. The lung scans weren't good news either. It showed that her lungs were severely damaged and that she had Chronic Lung Disease, which is why she was not coping with her breathing. The head doctor came and had a talk to us saying that the outlook was not good, and that we should prepare ourselves for the worst. We didn't believe them and told them not to worry. I don't know whether we were in denial about her being so sick, or if we really didn't understand fully everything that was going on.

But our wee one was a fighter and by day 30 she was tried back on CPAP. It was explained to us that this was an important day, if this didn't work it was unlikely she would make it off the ventilator. Things went smoothly and she stayed off the ventilator, thanks to some strong medicine to strengthen her lungs. She steadily got stronger from there.

Over the next few months she had ten blood transfusions and still had infections throughout her body, but she battled through. It was hard seeing other mums entering NICU and leaving again with their babies while we were still in intensive care.

But after three months in intensive care she was allowed to be moved from the incubator in to a cot, and was allowed to get dressed for the first time. Because she had been in a controlled environment at a set temperature for so long she had five layers of clothes on and looked like a tiny Eskimo. By the time she was four months old she was still on oxygen and still refused to drink, so she had a feeding tube inserted in her nostril (which she constantly ripped out). After many frustrating sessions with a Speech and Language Therapist she finally started drinking 40mls every few hours. A sleep study also showed that she coped quite well off oxygen and we were told that she didn't have to go home on oxygen which was the best news we could get.

So after 143 long days in hospital she was allowed to come home. It was a long, hard journey but we are so grateful that our wee girl is a fighter and made it through so many hurdles. Her lungs cleared up by the time she was three and now she is super tall, super skinny and super smart. We couldn't wish for anything more.


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