The Hindu : `Early detection of congenital defects vital'

Online edition of India's National Newspaper
Monday, Jan 19, 2004

Tamil Nadu

Tamil Nadu - Coimbatore

`Early detection of congenital defects vital'

By Our Staff Reporter

COIMBATORE, JAN. 18. Lack of awareness on the need to constantly monitor the condition of the foetus, in spite of the availability of state-of-the-art technology to detect congenital defects, is seen as a major factor contributing to birth complications.

The medical fraternity is of the opinion that even if there is considerable awareness on the importance of institutional delivery, much more ground has to be covered in terms of enlightening the public on utilising technology to detect defects in the foetus as early as in the 12th week of pregnancy.

A catalogue of disorders such as lung immaturity, difficulty in breathing, cardiac and intestinal problems, brain haemorrhage and vessel bleeding are detected pretty late, after the child is brought to the hospitals with at least one of the above, if not multiple complications. These complications are found in many premature babies.

The neonatologist at the K.G. Hospital, Sam Sathyanathan, says more than 60 per cent of the admissions to the neonatal intensive care unit attached to his department come with "unrecognised complications" that are invariably fatal. "These cases are mostly from a 200 km radius around Coimbatore and born at good obstetrics hospitals that focus on mother and child care." But, lack of infrastructure in their area, needed to detect defects in the foetus, allows the problem to worsen while the foetus grows. Either there will be complications resulting in delivery problems or the child is born with serious ailment.

Dr. Sathyanathan cites the case of a two-year-old child from the neighbouring Palakkad district in Kerala. "The child was suffering from haemorrhage, apparently after being pulled out with forceps using some force. The pressure of the forceps had caused the haemorrhage. But, the problem was not detected at the local hospital. Neither was the cause. A Caesarean section should have been performed as soon as complications in delivery were expected. This could have spared the child from intra-partum asphyxia, which is suffered by 43.35 per cent cases in the uterus itself.

A doppler study on the mother is essential to monitor the important parameters such as blood flow to the foetus. But, not even one-third of the total delivery cases come to hospitals that have critical monitoring facilities. In many cases, the pregnant woman goes to her mother's place for delivery. Invariably it is a village set-up with no critical monitoring facilities. "Education of the mother-to-be and the spouse is vital to create awareness on the risks involved."

They have to watch out for gestational (between conception and delivery) diabetes. The "large for date" babies (heavier than the normal weight at birth) are proof of the mother suffering from diabetes. "In fact, these babies are more sick than the smaller ones." Studies had revealed that 50 per cent of mental retardation cases were preventable if proper monitoring facilities during pregnancy and after delivery had been available to detect disorders.

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