Extremely Low Birth Weight in Preterm Newborn: A Case Report

Aim: The aim of the case report is to describe the management of Extreme Low Birth Weight Infant with presentations of prematurity, RDS and anemia.Methodology: A 20-year-old primipara was admitted in our hospital at 24 gestational weeks. The mother had premature rupture of membrane with oligohydramnios which was confirmed through ultrasound. The labor was augmented and mother delivered via spontaneous vaginal delivery at 26 gestational weeks, a live female infant at 690g birth weight with APGAR of seven at 1 minute, seven at 5 minutes and eight at 10 minutes. The infant first examination showed chest indrawing, deep breathing (R=61cycles/min, Pulse=113b/mins) and prostration (++), blood sugar (8.6mmols) and temperature of 34.3oc. The child also developed jaundice and anemia. Child was managed on maintenance fluids, nasogastric tube feeds, oxygen therapy and antibiotics 1st line, expressed breast milk, kangaroo Mother care (KMC), IPC and vital monitoring. The child was discharged at 54th day of life stable with no noted developmental delays. Findings: Specific problems that should be considered among the ELBW infants include thermoregulation, respiratory distress syndrome, cardiovascular problems, CNS, electrolyte imbalance, impaired glucose homeostasis, infection bronchopulmonary issues, ROP and anemia in prematurity. Our case had predominant presence of ineffective thermoregulation, RDS, electrolyte imbalance, anemia and risk for infections. Therefore, the survival and development of extremely low birth weight infants depends on holistic multidisciplinary approach during intrapartum, hospital stay and 1 year after discharge. Unique Contribution to Theory, Policy and Practice: The case emphasizes on the need for early initiation of keen monitoring and implementation of holistic management on premature and ELBW babies to prevent complications and improve on survival rate and outcomes. The case report highlights key problems that are manifested among ELBW infants and proper initiation of management immediately after birth can improve outcome and survival of the infant.