Times of India
11 March 2010
By Pratibha Masand

Expectant Mothers Can Come To Know Early If Baby Has Disease
Taking a decision, on whether to carry on with a pregnancy even if your foetus indicates that it will grow into a baby with Down’s Syndrome, has become a lot easier in Mumbai. With several city hospitals claiming they can detect whether or not a foetus has Down’s Syndrome in the 11th-13th week of pregnancy, Mumbai’s expecting mothers can actually go in for a planned abortion if they dread the choice of having a baby with the syndrome.

Previously, hospitals in the city would be able to detect chances of the foetus growing into a baby with Down’s Syndrome much later, possibly when the foetus would already be 15-18 weeks old. But, with abortion laws in India specifying foetuses cannot be aborted after 20 weeks, the old technology did not leave women and their gynaecologists adequate time to plan an abortion. The new technology seems to have taken care of these worries.

Using the First Trimester Screening (also known as ‘dual method’), highly experienced sonographists can screen Down’s Syndrome very early on. “Earlier, the only method of detection was the Triple Marker Test, which could be done only from 15th to 18th week. Now, with First Trimester Screening, the women can get their babies screened in the 11th to 13th week,’’ said Dr Sameer Dikshit, foetal medicine consultant at BSES Hospital in Andheri.

Moreover, the Triple Marker Test had 60-70% accuracy, while doctors claim the First Trimester Screening is 90% accurate. “None of these screenings can be 100% accurate. If we feel after a screening that a baby might have Down’s Syndrome, then we do further tests —like corium biopsy (in 11-13th week) or amniocentesis (done in 16-17th week), which confirm the syndrome,’’ said Dr Rishma Pai, gynaecologist in Jaslok and Lilavati Hospitals.

However, it takes experienced sonographists to observe the thickness of fat behind a baby’s neck or the flatness in the baby’s nose in an ultrasound photo, said gynaecologist Dr Suchitra Pandit, who does the dual marker test in Kokilaben Ambani Hospital in Andheri. “There are guidelines from the Foetal Medication Foundation, which vary with age group of the mother, her weight, height and weight of the baby, etc. So each case is different. However, generally, if we find more than 3.5 mm fat behind the baby’s neck, then it is a danger sign,’’ said Dr Dikshit.

“We generally conduct the nuchal translucency test (measuring fat behind the baby’s neck) only on high-risk women,’’ said Dr Ravi Ramakantan, head of radiology in KEM Hospital. “We start screening high-risk mothers from the 9th to 10th week itself,’’ said Dr Rekha Daver, head of gynaecology, JJ Hospital.

Another method includes checking the biochemical levels in the mother’s blood. “Generally, there are certain hormones a baby secretes, which get mixed with the mother’s blood through the placenta. So, we can check the increased levels of a hormone called Papp-A in the mother’s blood, which indicates the positivity for Down Syndrome,’’ said Dr Dikshit.