In a testament to the wonders of medicine, a baby that may be the "the most premature known survivor to date" has gone on to thrive, three years after she was born at under 22 weeks.
According to a new paper about her remarkable case, the little girl is developing normal motor and cognitive skills according to the standard scale - despite the unlikely odds she'd even live.
Full-term babies are, on average, born at about 40 weeks. If a baby is born before 37 weeks, it is classified as premature; and a 2003 study found the survival rate to one year of age for babies born at 23 was just 4.5 percent.
According to the American Academy of Pediatrics guidelines, an attempt to resuscitate is not recommended for babies born earlier than 22 weeks.
The tiny girl was born to Courtney Stensrud at the Methodist Children's Hospital in San Antonio, Texas. Her doctor, neonatalist Kaashif Ahmad, advised the new mother of the baby's chances. She requested that he try anyway.
"When the mother asked that we do everything for her daughter, despite having no reason to believe the baby would survive, I just made the decision to proceed with a vigorous resuscitation," Ahmad told CNN.
"So we placed her under an overhead warmer, we listened, and we heard her heart rate, which we were not necessarily expecting. We immediately placed a breathing tube in her airway. We started giving her oxygen, and really pretty quickly, her heart rate began to rise.
"She very slowly changed colours from blue to pink, and she actually began to move and began to start breathing within a few minutes.
Stensrud had gone into labour at 21 weeks and 4 days because a bacterial infection called chorioamnionitis had prematurely ruptured the foetal membranes.
The tiny baby was just 26 centimetres (10 inches) long and weighed just 410 grams (14.5 oz) - about the same weight as an American football. She wore her parents' wedding rings like bangles.
She was successfully resuscitated, but couldn't breathe on her own. She needed to be intubated and attached to a ventilator for 56 days. Because of this, she needed to be fed enterally - through a tube that fed expressed breastmilk directly into her stomach.
She didn't get to go home with her parents until 126 days after her birth - over four months.
Every year, more than 1 in 10 babies are born prematurely. That's 15 million infants around the world. Studies have also shown that being born prematurely often has long-term negative health effects, such as reduced lung capacity, motor impairments, cognitive impairments, and reduced bone mass.
However, two years after she was born, Stensrud's baby is completely normal, according to the Bayley Scales for assessing the cognitive and motor development of young children.
Stensrud calls the toddler a "miracle baby" and tells her story to offer hope to other mothers who may find themselves going into preterm labour, but Ahmad cautions against extrapolating too much.
"We have to be very cautious about generalising one good outcome to a larger population," he said.
"We reported this case because after this resuscitation she did well, but it may be possible that this is just an extraordinary case and that we shouldn't expect the same from other babies. We have to learn more before we can make any conclusions."
The case report has been published in the journal Pediatrics.
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