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A delicate fight for the tiniest lives

Bookmark and Share From conception to birth, each day of a pregnancy is vital in forming a human life. What starts as an unrecognizable mass of cells, dramatically changes over 40 weeks to become a living, breathing infant with 10 fingers, 10 toes — and maybe her mother's brown eyes. A work in progress
A dangerous diagnosis
A tiny girl with a mighty spirit is born
You've gome a long way baby

A work in progress
"A fetus goes through miraculous changes each week in the womb: organ systems mature, the lungs begin to function and infection-fighting antibodies are passed from mother to child," states Leonard Goldsmith, DO, Virtua Health's chief of neonatology. "When a child is born pre-term — that is before 37 weeks — she's still a work in progress and her growth must continue outside the womb." To mimic what a uterus and placenta provide for a fetus, the neonatal intensive care team offers preemies a warm, quiet, protected place to eat, sleep and grow. But even with leading-edge technology and the finest medical care, this presents a challenge that sends some families on an emotional roller-coaster ride.

A dangerous diagnosis
Ankila Chandran and Tom Hirata of Voorhees know this all too well. After six months of a perfectly normal pregnancy, Ankila was diagnosed with preeclampsia, a life-threatening condition characterized by high blood pressure and protein levels. Virtua's chief of maternal-fetal medicine, Ronald Librizzi, DO, immediately admitted her to Virtua West Jersey Hospital Voorhees, where she would deliver her baby 14 weeks early. Together with John Wilson, MD, Ankila's obstetrician, Dr. Librizzi coordinated her care in the hospital and introduced her husband and her to Dr. Goldsmith. "That personal attention really warmed my heart," says Ankila.

Dr. Goldsmith explained that their baby would be taken to the neonatal intensive care unit (NICU) right after delivery. There, a team of board-certified neonatologists, advanced practice nurses, neonatal nurses and respiratory therapists would care for the baby. "Dr. Goldsmith was realistic, but also reassuring," Ankila remembers. "He said the baby's condition would be critical, but that he had high hopes, having cared for many 26-week-old preemies."

A tiny girl with a mighty spirit is born
Ishani, who was named after a Hindu goddess representing power and strength, was born on Thanksgiving Day 2002, weighing just 1½ pounds and measuring less than 13 inches long. Though neurological problems are common in extremely premature babies, an ultrasound of her brain showed normal function. Still, she had a long fight ahead of her — facing difficulties that included fluid build up in the lungs that required her to be on a ventilator. She also was treated for retinopathy of prematurity, a potentially blinding disease. Faced with all these issues, Voorhees NICU nurse manager, Barbara Hansen, BSN, explains how life in the NICU can be emotionally draining for families. "A preemie's condition can change day to day, so we try to support families in any way we can." Ankila and Tom found reassurance from Virtua's community of doctors and nurses and from other NICU families. "The nurses personalized Ishani's isolette and made individual quilts for each baby in the NICU," remembers Ankila. "When Ishani reached two pounds, they made a sign announcing her achievement. Celebrating every milestone helped us stay strong." Ankila and Tom also found comfort in being able to take part in Ishani's care. "Because Ishani was so tiny and hooked up to so much medical equipment, the nurses had to teach us how to hold her properly, take her temperature and change her diapers. The staff never hesitated to answer questions, and we never felt excluded from the decision making." Hansen says family involvement is vital in the NICU, as some babies stay for many weeks until they can eat and breathe on their own and regulate their body temperature. You've come a long way baby
After 91 days in the NICU, Ishani left the hospital on February 25, 2003 weighing 6½ pounds. "It was a wonderful day," remembers Ankila. "It meant a lot to us that Dr. Goldsmith was there, especially when he finally told us, 'Go home, and enjoy your baby.'" Ishani is now a playful one-year-old. Despite some digestive problems, she is showing signs of continuing progress in Virtua's neonatal follow-up program, where her development will be monitored until age 3. "She'll take a little time to catch up, but she's now crawling, laughing, saying 'mama' and 'dada,'" says Ankila. Ankila continues: "The care we received at Virtua was the very best. And, everyone from the maintenance personnel and security guards to the doctors and nurses always made us feel comfortable. This is our hospital... it's almost like home."