12-minute response time and a 30-minute journey saves life of a pre-term baby boy from Shadnagar

After 7 years of marital bliss, a couple Navaneetha and Narender were blessed with a baby boy who was a preemie (preterm baby). On day 1 of life, the baby was admitted to a local hospital at Shadnagar in the Ranga Reddy district in Telangana.  The baby was treated with supplemental oxygen and due to worsening difficulty in breathing and respiratory distress, the parents were counseled to receive treatment from a higher centre, providing tertiary care services and advanced treatment options. Yashoda Hospital Somajiguda responded in 12 minutes of referral and the baby was transported to the hospital in 30 minutes. A team led by Dr. Sudha. B, a Senior Consultant Neonatologist, managed to retrieve the baby in an ambulance which was equipped with a state-of-the-art transport incubator with transport ventilator. Baby was brought to the NICU and admitted under the care of Dr. Suresh Kumar’s team of 6 consultants  namely; Dr Sudha, Dr. Veena, Dr. Jeevan, Dr. Samatha, and Dr. Sriveni.

Recounting the diagnosis, Dr. Suresh Kumar the Lead Consultant – Pediatric Critical Care and Pediatrics at Yashoda Hospitals Somajiguda said, “The baby had congenital pneumonia, an infection of the lungs which is usually seen in a very small proportion of newborns. The baby was put on ventilator support in view of severe difficulty in breathing; was treated with Intravenous (IV) antibiotics and supportive therapy with continuous monitoring by our expert team of nurses. The baby was on invasive ventilation with mechanical ventilator support for 3 days, after which the baby was extubated and supported with CPAP therapy (Continuous positive airway pressure), a non-invasive mode of ventilation and was later put on supplemental oxygen. The baby was on the mother’s feed throughout the stay.  He fully recovered and was discharged after 7 days of hospital stay.” 

On follow up, the infant was found to be doing well a week later, having gained weight with regular intake of feed. Thanking Dr. Suresh Kumar, Dr Sudha and the team of Yashoda Hospitals, the parents of the baby said “We were very scared when our baby couldn’t breathe and we were asked to visit another hospital, but coming to Yashoda Hospitals was the best decision, since our baby is now healthy and capable of breathing on its own. Even though it was a challenge for the team to transport the baby with such breathing issues, with the excellent transport services available at Yashoda Hospitals it was convenient and faster. In a nutshell, we are glad that the baby has survived and we are extremely grateful and impressed by the services provided by the Hospital and its doctors. “

Congenital Pneumonia generally refers to pneumonia that is already established at birth or occurs during the first week of life. It is an inflammatory disease of the lungs which is usually seen in a small proportion of infants. A complication during the labour or delivery process can increase the risk for an infant to have respiratory distress or conditions that mimic congenital pneumonia. To prevent congenital pneumonia, an appropriate management of maternal conditions that can result in an increased risk of infection in neonates should be taken, highlighted doctors at Yashoda Hospitals. Keep reading to understand the causes of pneumonia in newborns, its treatment and prevention.

Cause of Congenital pneumonia

According to doctors at Yashoda Hospitals in Hyderabad, congenital pneumonia is mostly caused by bacterial pathogens associated with early onset sepsis. Any past maternal history of bacterial or viral diseases such as hepatitis viruses, herpes, gonorrhea or syphilis can get transmitted to the infant. So, maternal history should be reviewed thoroughly to identify the maternal risk factors associated with congenital pneumonia and for other pathogens.

The maternal risk factors associated with the perinatal phase includes the premature onset of labour under 37 weeks of gestation, prolonged or premature rupture of membranes, maternal fever and maternal chorioamnionitis. A complication during the labour or delivery process can also increase the risk for an infant to have respiratory distress or conditions that mimic congenital pneumonia.

Prevention of Congenital pneumonia

Doctors at Yashoda Hospitals suggest that a universal screening for all pregnant women with presentation of threatened delivery should be done to prevent congenital pneumonia. In addition, appropriate management of maternal conditions that can result in an increased risk of infection in neonates should be taken.

“The incidence of congenital GBS (Group B streptococcus) associated pneumonia will decrease when the early onset GBS can be identified and prevented. A proper identification of the colonized mother should be done and peripartum antibiotic prophylaxis prior to the delivery should be started,” they said.

Expectant mothers who have had a previous child infected with invasive GBS disease should be counseled about the importance of sharing this information in the medical history in all the subsequent pregnancies as the newborn or infant should be kept under observation, screened and treated for at least 48 hours after the delivery. All prenatal lab screenings should be conducted in order to screen for maternal infection, which is one of the most important prevention strategies, they added.

Treatment of Congenital pneumonia

The doctors explained – The immediate management of a neonate with congenital pneumonia is focused to provide respiratory support to optimize the blood gas exchange, since adequate oxygenation is vital. CPAP may be used for infants with more severe blood gas abnormalities. Empiric antibiotic therapies should be started as soon as possible when congenital pneumonia is suspected. And the culture results are available. Inotropes should be used as clinically indicated. Tracheostomy is required for those infants with long term ventilation. Multi organ dysfunction is seen in infants and should be treated with appropriate choice of antibiotics based on the underlying pathogen.