Now, Docs can zero in on sonograph for ultrasound device, August 18, 2007

Now, docs can zero in on sonograph for ultrasound advice Malathy lyer I TNN

Mumbai: When Baby Mishra's faulty heart was mended within 15 hours of birth, the credit for the medical feat went, in part, to a much derided device the sonography machine.

Usually in the news for being the most misused medical tool to determine the sex of an unborn baby, a newer the sex of an unborn baby, a newer generation of sonography machines is emerging as a good way to detect malformations and diseases in unborn babies. “For a paediatrician or pediatric surgeon, a new class of disorders have emerged called the ‘antenatally diagnosed disorders’,” says associate professor (paediatric surgery) Arbinder Singal, Pediatric Surgeon & Pediatric Urologist at MGM Hospital, Vashi, Navi Mumbai. He has surgically saved the lives of 27 babies in the last one year, thanks to antenatal diagnosis.

An antenatally diagnosed disorder means conditions are diagnosed means conditions are diagnosed in the baby while she is still in the mother’s womb. Nair Hospital dean Dr. Sanjay Oak, himself a pediatric surgeon, says; “Antenatal diagnosis and counselling is changing lives. And its efficiency is improving every day with the availability of better ultrasound machines.”

Baby Mishra’s mother Sangeeta had gone for an ultrasound scan in the seventh month of her pregnancy when the radiologist told her about the foetus’s slowly beating heart. A colour Doppler scan then zoomed in on the problem: a congenially blocked heart. On the day Sangeeta delivered at a nursing home in Airoli, an ambulance from Wockhardt Hospital, Mulund, was stationed outside. The just-born baby was put on an IV drip and transferred to the hospital, where 15 hours later on Tuesday morning he was fitted with a pacemaker possibly the youngest in the city with such a device.

Exactly a year ago, TOI had reported about Aryan Nawle, who was born with a cancerous tennis-ball sized cancer on his liver. The tumour was picked up during mother Sneha’s eighth month ultrasound scan. Treatment started as soon as he was born and the tumour was surgically removed when Aryan turned nine months old.

Radiologists like Samir Shah say that USG (ultra-Sonography) can help in many ways, considering that it can provide a view of the beating heart of the foetus at seven to eight weeks and of major body organs after 14 weeks. “A specially advised foetal anomaly scan can pick up major congenital anamolies,” says Dr. Shah who has detected conditions ranging from the rare ‘Siamese twins’ to the relatively more common ‘hydrocephalus (swelling in the kidney).

The most common abnormalities seen on USG are hydronephrosis (swelling in the kidney), other kidney malformations like cystic kidney and absent kidney, spina bifida (defect in the spine), cardiac anomalies, chest malformations, cysts in the belly, intestinal obstruction, among others.

However, Dr. Shah rushes to add that not all anamolies can be picked up on an ultrasound would have some form of anamoly that can be picked up by an ultrasound, be it something as simple as an extra toe or cleft lip.” he adds.

Once an anamoly is detected, parents have an option of whether to continue with the pregnancy or terminate it. “It is our job to tell parents whether the child will be as safe outside as it is inside the womb.” says a radiologist.

Wockhardt Hospital’s Dr. Swati Gharekar; who helped diagnose Baby Mishra’s condition, however, believes that India has a long way to go with regards to antenatally diagnoses disorders. “It is certainly heartening to know that fetal anamolies are being picked up, but we need to do more.” she says.

For one, all USG machines should have two extra views and probes to facilitate easy diagnosis of hear anamolies. “If only this is done, we could save hundreds of babies who at present rush to us when they slip into a form of shock.” Says Dr. Gharkear.

Baby Mishra is doing a fine, say doctors

Doctors attending on Baby Mishra who made news for being among the youngest to be fitted with a pacemaker says “he is doing fine”. The device was carefully selected: a miniature version weighing barely 12gm as against the adult pacemaker of 150 gm was fitted to his infant heart. In Wockhardt Hospital’s paediatric ICU, Baby Mishra is awaiting a special visitor-his mother who is likely to be discharged from the Airoli nursing home where she underwent a C-sec operation on Monday. The prognosis is good for Baby Mishra, say the doctors who operated on him on Tuesday morning. “He won’t be able to sprint at the Olympics, but he can certainly go down the line though, he will have to return to change the batteries of the pacemaker or to get it upgraded.

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