Aims and Objective: To share the experience of pediatric surgeon while dealing with the birth defects in antenatal period with the changing law for medical termination of pregnancy in India.
Material and Methods: A retrospective observational study of 188 pregnant women presenting to the department of pediatric surgery for antenatal consultation. The women were followed up till the pregnancy was completed or terminated. Various parameters were noted down in the form of maternal age, educational status, gestational age, types of anomalies and organ system involved. There was change in medical termination of pregnancy (MTP) act which was relaxed in concern with gestational age.
Results: Mean gestational age (GA) of fetus was 27.26 weeks and 49 individuals had GA above 20 week. MTP rate in our study was 14.8%, where 6 terminations were considered unnecessary owing to increased anxiety. Anxiety level was high in 65 women. Educational status did not have a significant impact on the level of anxiety. Most common congenital anomaly was noted in genitourinary system. Most terminations and perinatal deaths were noted in Central nervous system (CNS) and cardiac system. More dilemma was involved in patients with suspected posterior urethral valve, congenital diaphragmatic hernia, CNS malformations.
Conclusion: Decision making in birth defects is a challenging task with the development in medical technologies. Most of them present after 20 weeks of gestational age. Relaxation of GA for MTP is going to be beneficial in dealing with serious anomalies. Couples should be given definitive plan of treatment after birth and sufficient time to answer their queries. In certain situations, the counseling should not be directive but should be supportive to help couple take a decision. Our decision should be bound with ethics, law and reasonable medical justification in helping parents to take the decision.