Triplets Admitted to AHC
Triplets account for approximately one in 1000 births worldwide. They are considered so exceptional in Cambodia that the government provides a $1,000 USD subsidy to the families of triplets. So when the newborn triplets Ponlok, Ponleak and Ponleu were admitted to the AHC Neonatal Intensive Care Unit (NICU), it was an uncommon event.
The triplets were delivered at a rural health centre, 60km from AHC. They were born seven weeks premature; all were a low birthweight, and all were seriously ill. They had difficulty breathing, a high fever and were not active, all signs of neonatal sepsis. The health centre staff rushed Ponlok, Ponleak, and Ponleu to AHC as the small health centre did not have the facilities to deal with premature babies in critical condition.
The AHC NICU has specialist equipment, personnel and training to deal with cases like this, and was capable of treating all three triplets at the same time. An antibiotic treatment of ampicillin and gentamicin was prescribed to all three to treat their sepsis infections. They were too small to feed unassisted so required feeding tubes, along with probiotic, multivitamin, and IV fluid treatment.
Ponlok, the only girl of the three, was the most seriously ill. She weighed just 1.5kgs, and had a serious case of hyaline membrane disease (HMD). This is a common problem with premature babies, caused when the under-developed lungs do not have enough tissue to reduce tension within the lungs. To treat Ponleu’s HMD the AHC staff provided treatment from the CPAP (Continuous Positive Airway Pressure) machine. This machine is crucial in relieving respiratory distress and pain while aiding recovery and growth.
Ponleak was admitted in the bed next to his sisters in the NICU, his condition was not much more promising than hers; he weighed just 1.7kgs and also required CPAP treatment. Ponleak and his sister would remain connected to the CPAP machine for the next 15 days. Both babies needed this life-saving equipment for over two weeks to help their underdeveloped lungs to breathe.
Ponleu, who was in the healthiest condition of the triplets, still weighed only 1.8kgs. He received antibiotic treatment for his neonatal sepsis infection and around-the-clock, one-to-one observation and care from AHC staff.
Cases like these are common at AHC but treatment needs to be immediate and of the highest quality in order for the patient to have any chance of survival. Without emergency care the triplets would not have been able to feed, their infections would have spread, and most notably, they would not have been able to breathe unassisted.
The triplets’ family were a notably strong and positive presence at AHC during their stay, despite the triplets requiring nearly a month of hospital care. The mother, who was fortunately healthy after birth, slept close to her children in the adjacent mother’s room for the entire stay, while the father stayed close by at a relative’s home. The mother received regular visits from the AHC breastfeeding counsellors and social work team. Though they were young parents, they were confident their three babies were receiving the best care available.
After five days of proper antibiotic treatment all three had recovered from their neonatal sepsis infections. But due to their premature complications, they all needed longer to gain weight and strength. Fortunately, the most dangerous time had passed as their sepsis infection had been treated effectively.
In total, Ponleu was discharged after 18 days at AHC, Ponleak required 26 days of hospital admission, while Ponlok needed the longest and most intensive care. She spent 28 days at AHC in total. After the duration of each of the newborns’ stays, they were gaining weight and breastfeeding normally, with no sign of long-term complications. All three left AHC healthy.