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.