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 on Sept. 19.
"We thought we were within a few hours to maybe a day" of Rumaisa's death, said obstetrician Dr. William MacMillan of Loyola University Medical Center in Chicago.
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, with her eyes open and crying.
"I feel blessed," said Dr. Jonathan Muraskas, professor of pediatrics and neonatal-perinatal medicine at Loyola's medical school, who has cared for Rumaisa and her sister, Hiba, since they were born. "To me it is a miracle, and God works through a lot of people at Loyola."
Rumaisa debuted publicly this week in a small room packed with more than 30 members of the media outside the Maywood, Ill., hospital's Neonatal Intensive Care Unit. She was born in the same delivery room and cared for in the same ICU unit as the previous record holder, Madeline Mann, who was born at just 9.9 ounces 15 years ago.
Wrapped tightly in a white blanket with blue and red stripes that matched her sister's, Rumaisa peered around the room, flailed her tiny arms and let out a tender cry as cameras repeatedly flashed.
When she was born, Rumaisa was 9 3/4 inches long and was 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 and are expected to go home over the holidays.
"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."
"It's a blessing," said the babies' beaming mother, Mahajabeen Shaik, 23. "It's a great blessing."
She carried Rumaisa and Hiba for 25 weeks and 6 days -- every last one of them critical. The youngest premature baby to survive was carried to 23 weeks, doctors said. Normal pregnancies last about 40 weeks.
Rumaisa's birth weight was more typical for an 18-week fetus, Muraskas said, but the extra time she spent in the womb was more vital than her size.
"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.
"Boys are wimps. I said that with Madeline Mann," he said. "I mean, thank God they're girls because I don't think we'd be sitting here today."
Hospital officials said they did not know the cost of all the care, but estimated it averages $5,000 a day at Loyola for a premature baby.
For the first month, the babies were in incubators and hooked up to IVs, so their parents could not hold them until their second month.
They underwent laser surgery to correct potential retinal problems common to premature babies and ultrasounds show their brains are not bleeding -- another common complication.
They still are receiving a little oxygen as a precaution because premature babies' lungs are not fully developed, but doctors say the twins are bottle-feeding and already could have gone home safely.
"We won't know for a year or two, but right now, Doctor 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 India, their homeland. Rumaisa's name means "white as milk" in Arabic, and Hiba means "gift from God."
"We want to give them a good education and we want them to be good human beings, good citizens," their father said. "And she wants them to be doctors."
"Doctors, yes. Of course, of course," their mother said laughing.
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