The Indian Express: Mumbai: Thursday, June 28, 2018.
AT LEAST
1,290 cases of congenital birth defects have been recorded in the two major
municipal hospitals in Mumbai, the King Edward Memorial (KEM) Hospital in Parel
and the BYL Nair Hospital in Mumbai Central, since 2011. The most common
anomaly among these cases, data from KEM Hospital shows, is congenital heart
disease.
Between 2011
and 2015, 395 children were born with congenital heart diseases in KEM
hospital, a condition that has witnessed a steady rise in incidence, from 66 to
95 cases in five years.
The data is
part of information received under the Right to Information (RTI) Act by
advocate Tushar Bhosale. While Sion Hospital maintains no data on birth
anomalies, KEM hospital recorded 778 cases from 2011 till 2015 and Nair
Hospital recorded 512 cases from 2011 till 2017.
Congenital
heart defects are the most common among these cases, followed by neural tube
defects and Down Syndrome, the information showed. Neural tube defects affect
the spine or brain, and are usually caused by maternal folate insufficiency,
where development deficiencies are seen in the foetus. Down Syndrome affects
mental and physical growth of the baby.
“There is no
treatment for Down Syndrome. And that is why pregnancy scans play an important
role, so that a couple can make a decision whether to abort the foetus or not,”
said Dr Paras Kothari, head of paediatrics in Sion Hospital, adding that most
defects such as congenital heart, cataract, cleft lip, hydrocephalus can be
corrected after a child’s birth.
“In USA,
foetal surgeries happen routinely to rectify anomalies. But in India, such
procedures are yet to be undertaken,” he added.
Most birth
defects are diagnosed between 16-18 weeks of pregnancy. Gynaecologist Nikhil
Datar, medical director at Cloud Nine hospital, who aids couples wanting to
seek abortion beyond 20 weeks’ gestation due to birth anomalies, however, said
that several defects may take longer to get diagnosed. “In India, as the
Medical Termination of Pregnancy Act caps abortion at 20 weeks, for defects
diagnosed later, couples find it legally challenging to abort a baby. We need
an amendment in the Act to extend abortion limit,” Datar said.
“Cardiac and
neurological abnormalities are difficult to pick up. They may be sometimes
diagnosed after 20 weeks. In case of Down Syndrome further investigation is
required to confirm the anomaly,” said Dr Datar.
According to
Nair Hospital’s neonatal department, newborns are commonly screened for
physical deformities, heart disease, hearing abnormalities, cleft lip or palate
and undergo X-ray for possible deformities.
Birth defects
can be caused by genetic or chromosomal factors, or sometimes exposure of
pregnant mothers to alcohol, tobacco or radiation. Maternal diabetes is also
responsible for birth defects, experts said. “But 50 percent of congenital
anomalies cannot be linked to any specific cause,” said Dr Ruchi Nanavati, head
of the neonatology department at KEM Hospital.
What has
remained heartening in the records was that no newborn was abandoned by parents
following diagnosis of birth defect. Mumbai records 1.5 lakh births annually,
and about 410 births every day. In most cases, hospitals provided treatment to
rectify birth defects.
Nair Hospital
detects and treats cases of cleft lip and palate, congenital diaphragmatic
hernia, gut atresia, hydrocephalus amongst other common birth anomalies. KEM
Hospital treats a wider spectrum of anomalies including retinopathy, deafness,
cataract, cleft lip, along with neural tube defect and Down syndrome.