As a result of preterm birth, an infant delivered before 37 weeks of pregnancy often requires specialized care. Babies delivered extremely early, such as those born at 28 weeks in the womb or sooner can be cared for only at certified Level 3 Neonatal Intensive Care Units.
Piedmont Newnan Hospital received certification from the state to begin operating as a Level 3 NICU in the early part of 2015, and was then able to offer services to extreme preterm infants and delivering mothers, as well as those with other serious medical issues or illnesses.
“Piedmont Newnan can now confidently care for the sickest of the sick — the smallest infants — requiring the highest level of care,” explained Jennifer Key, Director of Women’s Services at the local hospital. “The earliest in pregnancy an infant has been delivered at Piedmont Newnan is 23 weeks.”
Not long after receiving certification, the local facility expanded the Women’s Services Department to include the private NICU and additional Labor, Delivery and Recovery rooms.
“The Level 3 NICU has three triage rooms for patients preparing for cesarean sections or checking to see if labor has begun,” said NICU Clinical Manager Ashley Maxwell. “The unit also has full-time anesthesiologists available for labor, pain and emergency delivery.”
The hospital also added two board-certified neonatal care physicians, Dr. Francisco Velez and Dr. Adegboyega Aderibigbe, both of whom are capable of providing the 24-hour coverage in the unit to babies born as early as 24 weeks.
Dr. Aderibigbe, or “Dr. Ade” as he is known by co-workers, believes offering this type of specialized care for preterm infants in the county will allow for a better long-term outcome for the baby.
Prior to Piedmont’s NICU addition, extremely preterm deliveries had to be redirected to a Level 3 NICU located in Columbus, nearly 72 miles away.
“Mom spending time with her baby after birth and being able to hold the infant nurtures the infant’s nervous system and can improve the long-term outcome,” said Aderibigbe. “In our case, the delivering mom has likely already located a local pediatrician and other medical providers. So we can then all work together in the care of the baby.”
In a behind-the-scenes look at the inner-workings of the new Piedmont NICU, Maxwell and Key offered an account of the facility’s recently delivered quadruplets. The four naturally conceived infants were the first set of quads ever to be delivered in Newnan.
“The most important part of the quadruplets’ delivery was planning ahead,” said Key. “The operating room was set up a month in advance.”
Nearly 20 specialists were in the large delivery/operating room as the quadruplets were born. Also known as the “quad squad” the team of physicians, neonatologist, coordinators and nurses were on hand to care for each baby as he or she arrived into the world.
“Four omnibeds were brought in and the respiratory team was stationed just outside of the room with all of the equipment needed to transport to babies into to NICU.”
Kourtney Miller, mother of the quadruplets delivered at the local facility at 29 weeks gestation, was able to visit the NICU months prior to the birth and ask questions of the physicians and staff. Because of Piedmont’s Newnan location, Miller was able to remain active until the last moment of her pregnancy. The local mother of five was able to avoid bed rest and could quickly reach the nearby hospital in the event of an emergency or with any other concerns.
“Every single detail was planned and practiced ahead of time,” explained Key. “The squad even practiced moving beds and other furniture around to test the level of noise.”
Preterm infants require a very low level of stimulation, according to Key. Even with 20 people involved in the delivery, the cesarean operation and aftercare of the infants was done as calmly and as quietly as possible.
“Everyone was whispering during and after the delivery,” Key said. “Part of the NICU environment includes minimal stimulation to the infants.”
According to Maxwell, the hospital’s neonatologist led the way for everyone involved.
“Dr. Ade led the team with amazing confidence,” Maxwell said. “He was so quiet, calm and organized. Everyone involved performed amazingly well.”
Once the babies were delivered, Aderibigbe intubated each infant, one at a time in a planned and practiced performance.
“We got the call at about 7:15 and had about four hours to prepare, but we were ready,” Aderibigbe said. “It was all about the teamwork.”
According to the neonatologist, the staff was and is always prepared for any type of emergency and receives updated training and practice on a regular basis.
“We prepare for every preterm delivery and handled the quadruplets with the same care as every preterm delivery,” Aderibigbe said. “Airway management is first, along with gentle handling, minimal stimulation — no chaos. Each baby had his own team and each team member knew their roles.”
Once each of the four Miller babies was stable, the three boys and one girl were transported to the NICU, just feet away from the operating area.
The babies will remain in separate, private, but adjoining rooms until each infant has reached all of the milestones required for him or her to be released from the unit.
Miller was able to begin spending time with each infant in her arms just before Christmas. The local mom is doing well and makes the short drive to Piedmont Newnan Hospital every day to visit her new additions, a practice highly encouraged at the facility.
“You can’t really quantify these things,” Aderibigbe said. “But being close to the infants as often as possible makes a very big difference.”
The local hospital uses a donor breast milk program and encourages new mothers to begin pumping breast milk as soon as is possible. Preterm infants are given breast milk through a feeding tube in order to provide the babies with the best nutrition.
Aderibigbe added that Piedmont Newnan’s Level 3 NICU is a unique unit, especially in offering private rooms for infants. Rather than a single, open room with several incubators, the private spaces at Piedmont allow for further management of stimulation to the preterm infants.
“The first moments of life can predict the baby’s overall outcome — and every moment counts,” said Key. “We really just want to provide the safest environment and the best care at birth.”