Neonatology is a specialised area of medicine that refers to the care of babies who are sick at birth, premature babies, and babies born with multiple physical anomalies. NRG Newborn Intensive Care Unit (NICU) provides 24 X 7 care to sick babies by trained professionals in a safe setting. The unit is headed by Dr. A.G. Karthikeyan who has worked in the United Kingdom for 12 years in various positions before returning to Chennai. The NICU services will be provided by a professional team of consultants, nurses, and other allied professionals with relevant training, experience and care delivery under a single roof. The unit has a 7 bedded State-of-the-Art NICU with an isolation room. Separate rooms are available for consultation and counselling, breastfeeding room for mothers in a separate area, provision of Neurodevelopment and Early stimulation services for premature babies.
A team of senior doctors and nurses will be assembled to receive your preterm baby. Your baby will need a period of resuscitation (to help initiate and stabilise breathing and heart rate) by this team. The baby may be shown to parents before baby is taken to the neonatal unit for further treatment. Your baby will be started on intravenous fluids, various medications like antibiotics. Your baby will get some 'lines' placed through veins and arteries in the umbilicus. These are useful to provide fluids and medicines, monitor blood pressure, do blood tests in the first few days of life. Your baby will get regular blood tests, ultrasound scans of the brain and regular updates from your doctor. Your baby may develop various complications of prematurity. These are detailed in the subsequent sections.
Infection (often called sepsis) is a common problem in newborn babies due to their small size and presence of various 'lines' to monitor and treat these babies. Despite the various steps taken to minimise infections (like strict hand washing by parents and professionals when touching the baby), infections still occur. The majority of infections can be cured completely. However, some infections are severe leading to various complications in the baby. You will often find babies being treated with strong antibiotics for suspected infection during their stay in the neonatal unit.
Ductus arteriosus is a small blood vessel connecting two major blood vessels in the heart. This is critical to the baby's life while being inside the mother's womb. Once the baby is born, the ductus arteriosus should close in the first few days of life. In premature babies, the ductus arteriosus may remain open after birth resulting in a condition called patent ductus arteriosus (PDA). This may not require any treatment. However, in some babies it may prevent the baby to come off the breathing machine. In such circumstances, PDA may need treatment with medications to close it. Rarely, surgery is needed to close the duct.
Premature babies may remain attached to the breathing machine or require oxygen for a long period of time. When a premature baby requires ventilation or oxygen at 36 weeks postconceptional age, the babies are said to have chronic lung disease. This means that the baby's lungs are severely affected and that the baby is likely to need oxygen for a longer period of time. These babies deteriorate rapidly even with minor respiratory infections.
This refers to infection and inflammation of the bowel (intestines). Premature babies are prone to develop NEC due to their small size and immature bowel. The majority of babies who develop NEC require a few days of antibiotics and get better. Rarely, some babies may need surgery to treat their NEC. During the treatment of NEC, the baby's feeds will be stopped for a few days. To provide nutrition to the baby during this time, the doctors may need to give a special form of intravenous fluids called total parenteral nutrition (TPN). This may require placing a special line called 'longline 'to deliver the TPN.
Preterm babies have fragile blood vessels in their brain. These are likely to bleed easily into the brain. These are called 'intraventricular haemorrhages'. There is a range of severity of these haemorrhages – Grade 1 being smallest and Grade 4 being extensive. The outcome of babies varies depending on the grade of the haemorrhage. Sometimes the bleeding can be severe leading to a lack of blood flow to certain parts of the brain. The brain cells in these areas die and are replaced with tiny holes called 'cysts'. The long-term outcome of these babies depends on the location of these cysts in the brain. Occasionally, blood clots can block the flow of brain fluid (called cerebrospinal fluid) from the brain leading to accumulation of fluid in the brain – a condition called hydrocephalus. This may require surgery and lead to long-term complications.
Newborn babies are particularly prone to infections due to their inability to fight organisms due to a immune system. They can be affected by bacteria, viruses, and rarely fungus which can spread in their blood and causes symptoms of infection.
The symptoms are common to all forms of infection in newborns. They can develop poor feeding, become less responsive, high or low temperature, unusual crying, irritability, breathing difficulties to name a few.
The baby will need various investigations like blood tests, urine tests, tests of spinal fluid, X-rays, and occasionally ultrasound scans. The doctor attending to the baby will be the best person to decide which tests are relevant.
The baby will be treated with antibiotics to fight the infection. These antibiotics will be given intravenously through a vein for a few days. Different infections will need different lengths of treatment and duration of stay in the hospital.
if urgent. The NRG staff will ensure that you receive the best possible care.
