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News | July 1, 2024

Baby born at 22 weeks survives, thrives, thanks to Walter Reed team and parents

By Bernard Little, WRNMMC, Office of Command Communications

Aida Sall Diop and U.S. Navy Lt. Cmdr. Alioune Diop welcomed their newborn daughter, Mariam Aliyah, who was born October 31, 2023, at Walter Reed National Military Medical Center at just 22 weeks and five days gestation, weighing 460 grams (1.01 pounds). She spent five months in Walter Reed’s Neonatal Intensive Care Unit (NICU) before being discharged.

“We will be forever grateful to the Walter Reed NICU team for going above and beyond to keep our daughter alive, as healthy as possible, while keeping us sane in the process,” shares Diop.

“She’s thriving,” said Aida, who explained a bacterial infection that reached the amniotic fluid and caused the premature delivery.

“I was the attending neonatologist present at the delivery of Mariam and took care of her afterward for the first week of her life,” Army Maj. (Dr.) Mathew Harrell explained.

“Ms. Diop was admitted due to preterm labor, and when it became apparent that her labor was unable to be stopped, our OBGYN colleagues consulted us to meet with Diop and her husband. Our team resuscitated Mariam in the delivery room and transported her to the NICU,” Harrell added.

“Infants born at 22 weeks gestation are extremely fragile and small,” Harrell continued. He added that with Mariam coming into the world weighing barely one pound, her breathing was compromised.

“Babies born this immature require breathing tubes placed in the delivery room, and they are placed on special neonatal ventilators until they are more mature,” Harrell explained. “Every organ is also immature, especially blood vessels in the brain, which have a high risk of rupturing causing bleeding into the brain.”

“Mariam required many interventions in her first weeks of life to keep her alive and to allow her body to mature,” Harrell added.

While in the NICU, Mariam relied on a ventilator to help her breathe for more than two months. She had bacterial sepsis at the time of birth that many infants born prematurely would not have survived, her physicians explained. In addition, later in her hospital stay, she developed a bone infection that spread throughout her body, but she survived after receiving antibiotics.

“She developed numerous health conditions expected at a baby born that premature, including bacterial infections, chronic lung disease, and retinopathy of prematurity requiring eye surgery,” said Harrell.

U.S. Army Capt. (Dr.) Brian Graziose, a neonatology fellow who was also present following Mariam’s birth and her first day of admission to the NICU, shared that the care Harrell and the team provided Mariam immediately following her delivery was “the most important single hour” during her entire five-month hospitalization at Walter Reed.

“Mariam had her breathing tube placed with the transition to a ventilator, IV placed to provide dextrose-containing fluids, umbilical central lines placed for antibiotic administration, and she was put into an incubator all within about an hour’s time, which is an incredible feat when taking care of such a small baby,” Graziose explained. “Every access point is extremely smaller, including the airway, blood vessels, and umbilical cord, but having an infant ventilated, with appropriate blood sugars, receiving antibiotics, and in an appropriate temperature controlled humidified environment not only saves a premature infant's life but also protects their brain to improve life after the NICU,” he added.

Mariam was discharged from Walter Reed March 22, 2024, shortly after her mother’s original delivery date, Harrell shared. “She was discharged home on oxygen, given that her lungs were still immature but growing,” he added.

“Mariam is doing very well since discharge from the NICU,” Harrell added. “She is gaining weight and obtaining milestones appropriate for an infant born at her premature age. She still requires oxygen at home for her lungs, but she is eating everything by mouth.”

“Our team at Walter Reed did a fantastic job in the delivery room stabilizing Mariam and managing her afterward,” Harrell stated. “The nurse and doctors all cared very much for her, and she is the most premature infant survivor we have discharged from our NICU.” He credits all the neonatologists, residents, nurses, and respiratory therapists who participated in Mariam’s care for her positive outcome thus far. “They are too numerous to name, but all contributed.”

“It’s cliché, but the expression, ‘It takes a village,’ is fitting in the case of Mariam,” Graziose agreed. “The team of caregivers included nurses, respiratory therapists as well as residents, fellows, and attending physicians, and there was not a single person that came into the NICU in those five months that did not take it personally to make sure Mariam received the best care possible. The nursing team diligently watched her every minute of every day while she was critically ill, and even though Mariam may have had one nurse assigned to her any given day, she was everyone's patient,” he added.

U.S. Air Force Capt. (Dr.) Sidney Zven, a neonatology fellow at Walter Reed, agreed, adding that “Walter Reed has an extensive list of pediatric subspecialties, and almost all of them contributed to Mariam’s care. Pediatric Surgery, Pediatric Gastroenterology, Pediatric Neurology, Pediatric Endocrinology, Pediatric Orthopedic Surgery, Pediatric Cardiology, Pediatric Infectious Disease, Pediatric Pulmonology, Pediatric Hematology, Neonatal Dieticians, and Neonatal Pharmacists were all involved in Mariam’s care. It quite literally took ‘a village’ of experts to take care of Mariam, and her success is partly attributable to the phenomenal care she received by Doctors Harrell and Graziose, but also highlights the immense capabilities that Walter Reed offers for pediatrics.”

Most importantly, Harrell added, “Mariam’s parents showed all of us amazing grace during their daughter’s admission. They never lost faith in Mariam’s ability to fight through all of the odds, and they were such a wonderful family to take care of. We all love the Diop family so much, and we wish them the best success in life moving forward,” he said.

Graziose agreed, adding, “It also can't go unsaid that despite working their regular jobs, Mariam's parents spent time every day at her bedside and the care they provided in joint decision-making with the medical team, holding and feeding Mariam, changing diapers, and lifting the spirits of the medical team cannot be underappreciated,” he shared. “By the time the family was discharged, Mr. and Mrs. Diop felt like family to the team.”

“Lastly, and most importantly, Mariam deserves the most credit of anyone. She is one of the strongest patients that I have ever taken care of and had numerous reasons to have a bad outcome or possibly not survive at all,” Graziose continued. “Female infants born at her size, at 22 weeks, without prenatal steroids being given, only have about a 20 percent chance of survival despite all of the advances in neonatology. That number is even lower when there are multiple significant infections during the hospitalization. However, Mariam not only survived but thrived, and that is nothing short of miraculous,” he added.
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