MUMBAI: The Bombay high court recently directed that a foetus born alive during an emergency abortion past the 27th week of pregnancy on a woman with a hole in her heart must not be taken out of Parel’s KEM Hospital.

“The infant is not to be taken out of the hospital against medical advice,” said Justices Gautam Patel and Neela Gokhale on August 9. They had been told the woman had “delivered a live infant” after it had allowed the medical termination of pregnancy (MTP) to save the woman’s life.
The woman and her husband, both in their 20s, from Silvassa in Dadra and Nagar Haveli had moved the HC, seeking permission for MTP as she was beyond the legally permissible 24-week limit.

In March, she had learnt she was pregnant. On July 25, she was admitted to a local hospital with a bad cough and breathlessness. It was found she has a 20mm hole in her heart. She was advised to terminate her pregnancy and referred for a cardiologist’s opinion.

MTP

The couple left Silvassa in an ambulance around 11pm on July 30 and reached KEM Hospital on July 31. She was in a critical condition and they were told that in view of life-threatening conditions-hole in heart (atrial septal defect), a lower respiratory tract infection and severe pulmonary arterial hypertension-she was at high risk if the pregnancy continued.

MTP1

The Bombay high court received a detailed report from KEM hospital’s medical board on August 3 on the condition of a woman from Silvassa who had approached it for permission for an emergency abortion as she was beyond the legally allowed 24-week period but was critical after being diagnosed with a hole in her heart and other complications.
“Continuation of her pregnancy involves a high risk to the life of the first petitioner, and/or of grave injury to her mental health and wellbeing. It is causing immense anguish, suffering and stress to the petitioner and constitutes a grave injury to her health and well-being,” her petition in HC stated.
The judges noted the “significant” opinion of the cardiologists and the finding that “while medical termination carries a risk, this may be less than the higher risk of 30% to 56% of likely maternal mortality if the pregnancy is carried to term”.
Neonatal evaluation said the child may be born alive.
The board recommended “that pregnancy may be terminated but with high risk and consent from the patient and her relatives”. The judges then directed that a formal signed consent be obtained from the couple.
On August 7, after perusing the signed consent forms, the judges permitted MTP to be carried out at the earliest. It was carried out on August 8.
On August 9, BMC’s advocate Sagar Patil submitted a note from the hospital that “the patient tolerated the procedure well and delivered a 484gm baby” who was admitted in NICU and the mother is maintaining vitals such as blood pressure, pulse and saturation.
The couple’s advocate, Rebecca Gonsalvez, said that her condition is stable. The judges directed that “as the patient has a host of other medical issues, she is not to be discharged until she is found medically fit.” Also, “the parents shall not attempt” to take medical discharge of the child.
The judges will take an update on August 21.


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