Twins born prematurely at 24 weeks brave hernia, heart defect to survive

Chennai: Doctors at Chennai hospital gave a new lease of life to twin sisters, termed “miracle babies” born prematurely at 24 weeks.

The babies weighing 620 gm (twin 1) and 720 gm (twin 2) underwent surgeries for managing hernia and a congenital heart defect, and were on ventilator support for two months, said the doctors at Cloudnine Hospital, Chennai.

“In this case, both the twins were born micro-preemies at 24 weeks and are indeed miracle babies as they had to undergo two major life-threatening surgeries for treating hernia and Patent Ductus Arteriosus (PDA), a congenital heart defect. Both the twins were very sick, and their survival was doubtful in the early days of birth,” said Dr Dhilip Kumar S, Senior Consultant – Neonatologist and Paediatrician at Cloudnine Group of Hospitals, Chennai, OMR branch, told IANS.

“They suffered from chronic lung disease and were on ventilator support for two months because their lungs were too immature to wean off the ventilator support. Many times we as doctors felt that these twins would not survive but patience and perseverance are the key to managing these extreme preterm babies,” Dr. Dhilip added.

The girls were born to a Chennai-based couple after multiple failed pregnancy attempts. The mother, aged 36, was diagnosed with an incompetent cervix during a routine hospital checkup. She also had a medical history involving chronic hypertension, fever, and amniotic fluid leakage.

During the 15th week of her pregnancy, she underwent cervical cerclage -- a procedure in which the cervix is temporarily stitched and closed. However, at 24 weeks, the mother's cervix prematurely opened, weakened, and shortened, while she was carrying twin babies in her womb and experienced persistent high blood pressure and fever.

Shortly after birth, the babies had a drop in weight to 520 gm (twin 1) and 590 gm (twin 2) and also faced breathing difficulties and required ventilator support.

Neither of the twin sisters opened their eyes for the first two weeks, and their length measured a little over 13 inches.

Later, twin 1 was diagnosed with stage 4 chronic lung disease, experiencing multiple lung collapses and unsuccessful extubation attempts, leading to prolonged dependence on oxygen for 90 days in the neonatal intensive care unit (NICU).

She was also diagnosed with an inguinal hernia due to immature abdominal wall muscles, necessitating surgery to correct the condition.

Twin 2 did not cry at birth and also exhibited a low heart rate along with skin bleeding. An echocardiogram revealed the presence of a large patent ductus arteriosus (PDA) -- a congenital heart defect where the ductus arteriosus fails to close after birth.

While the ductus arteriosus serves as a vital foetal circulation route, allowing blood to bypass the lungs before birth, it should naturally close shortly after birth. However, in Twin 2's case, medical treatment failed to produce the desired response, resulting in the need for open-heart surgery to address the condition, the doctor said.

Following 105 days of stay at the hospital, the twins were discharged to return home while they weighed 2.2 kg (Twin 1) and 2.3 kg (Twin 2), respectively, the doctors said.