The federation of Obstetrics and Gynaecological Societies of India (FOGSI) observes ‘Foetus Day’ October 31 to sensitise communities about the possibilities in preventing unusual outcomes in newborns. Two to three per cent of live-born babies are found to have anomalies at birth. Chromosomal anomalies are the major causes of pregnancy losses and newborn deaths.
These contribute to about 50 per cent of abortions during the first three months. They also cause abortions in 2nd three months in 15 to 20 per cent, Besides, death inside mother’s womb during the last three months of pregnancy amounting to delivery of dead babies can occur as a result of chromosomal abnormalities in about 6 per cent of cases.
Common genetic disorders leading to severe degree of handicap occur in conditions such as thalassaemia, haemophilia, Down’s syndrome and muscular dystrophy. Conditions such as thalassaemia and haemophilia require frequent life-long blood transfusions and Down syndrome babies are born with mental retardation. Down’s syndrome affects 1 in 1,150 babies and beta thalassaemia major affects 2 in 2,700 babies. That translates to 9,000 such cases diagnosed each year.
With advances in cytogenetics and molecular studies, prenatal diagnosis of intractable conditions can be made much early in pregnancy. The top cause of death of children below one year of age is premature birth. Such pre-term births are as high as 25 per cent in developing countries such as ours. Preterm births in the country have not declined over the last 50 years despite significant advances in the science related to preterm delivery. In fact, premature births are increasing.
Advances in foetal medicine have made prediction and prevention of preterm births possible. Seizure accompanied by high blood pressure during late pregnancy, called eclampsia, constitutes an alarming condition among pregnant women. Foetal medicine offers adequate scope for predicting the condition.
Another problem observed is that babies are often underweight at delivery. This condition is found even among women from well-to-do families who have received adequate nutrition and amenities required during pregnancy. Foetal medicine is well-equipped to take care of them.
Twin pregnancies pose serious challenges to the mother, the babies and even the doctor in attendance. They are accompanied by many complications and the death rate among newborns is higher. Here, too, the most acceptable solution is foetal medicine.
Intrauterine foetal surgery is one of the most unbelievable developments that the community of gynaecologists has witnessed. Foetal surgery involves a broad range of surgical procedures that treat birth defects when the baby is in the mother’s womb.
One such defect is spina bifida; it is a disabling congenital disorder in which the bones of the spine do not close properly around the spinal cord, leaving the nerves exposed and vulnerable to damage. Spina bifida babies are often born with their lower limbs paralysed and with other disabilities.
One key factor that helps mothers to-be to prepare for their pregnancy and outcomes, such as the ones discussed, is ‘preconceptional counselling’. It ensures safe pregnancy and an optimal state of body and mind for mother and child. Preconceptional counselling and state of the art foetal medicine can help every mother and child enjoy the fruits of good health.
Dr Durga Shankar Dash is a gynaecolosist, sexologist and reproductive health consultant. He is member, Governing Council, FOGSI and President, AHPO. e-Mail: doctordurga@gmail.com
