Rumaisa Rahman was dying in the womb because of her mother's severe high-blood pressure and the competition with her larger fraternal twin. But before moving to save her, doctors...
CHICAGO — Rumaisa Rahman was dying in the womb because of her mother’s severe high-blood pressure and the competition with her larger fraternal twin. But before moving to save her, doctors had to balance the need for continued gestation that is crucial to the survival of premature babies.
The twins’ original due date was Christmas. Doctors decided to deliver them by Caesarean section Sept. 19.
“We thought we were within a few hours to maybe a day of [her dying],” Loyola University Medical Center obstetrician Dr. William MacMillan said yesterday.
Rumaisa, believed to be the world’s tiniest surviving baby, weighed just 8.6 ounces — so small that her doctors, in disbelief, weighed her in the delivery room three times. But they say she was born vigorous and pink, crying and with her eyes open.
The tiny girl was called “a great blessing” yesterday by her mother, who is preparing to take her and her twin home from the hospital.
Their mother, Mahajabeen Shaik, said she didn’t “have the words to say how thankful I was” when she first got to hold her children in their second month.
When she was born, Rumaisa was 9-3/4 inches long and given about a 50 percent chance of survival. She’s now about the size of a football in her father’s arms — almost 13-1/2 inches long and weighing 2 pounds, 10 ounces.
Doctors say she and her sister — who was about 1 pound, 4 ounces at birth and now is 5 pounds — are doing well. Hiba could be released from the hospital by the end of this month, with Rumaisa following as early as the first week of January.
“I was really nervous when I [first] saw the babies because they were too tiny,” said their father, Mohammed Abdul Rahman, 32, a customer-service representative from Hanover Park, Ill. “There were a lot of questions in my mind. ‘The baby is 8 ounces, how’s she going to grow?’ But I’m thankful to Allah that everything’s been fine.”
Shaik carried Rumaisa and Hiba for 25 weeks and 6 days — every last one of them critical. The earliest extreme for a premature baby to survive is 23 weeks, doctors said, while normal pregnancies last about 40 weeks.
Rumaisa’s birth weight was more typical for an 18-week fetus, but the extra time she spent in the womb was more vital than her size, said Dr. Jonathan Muraskas, professor of pediatrics and neonatal-perinatal medicine at Loyola’s medical school.
“The biggest misconception that can come out of here is that 8- and 9-ounce babies normally will survive,” Muraskas said. “This is an extreme case and it has to do with gestation.”
Another important factor: The twins are girls. Of the 62 newborns worldwide since 1936 who have survived with birth weights of less than 13 ounces, 56 have been female, Muraskas said. Baby girls, he said, are just heartier and more resilient.
Hospital officials estimated the cost of care averages $5,000 a day at Loyola for a premature baby. The twins are covered by Medicaid, officials said.
Muraskas said the twins were placed on ventilators for a few weeks and fed intravenously for a week or two until nurses could give them breast milk through feeding tubes, and then bottles after about 10 weeks.
Ultrasound tests have shown no bleeding in their brains, a common complication in premature babies that can raise the risk of cerebral palsy. They still are receiving a little oxygen as a precaution. They had laser surgery for potential vision problems.
“We won’t know for a year or two, but right now, Dr. MacMillan and I are very optimistic that they’re going to be normal,” Muraskas said.
The twins are the first children for the parents, who were married in January in Hyderabad, India, their hometown, but are permanent U.S. residents.
“We want them to be good human beings, good citizens, and she wants them to be doctors,” said Rahman, looking at his wife.
“Doctors. Yes, of course, of course,” she said, laughing.