It Ain't Over 'Til It's Over

This morning, I found this disturbing story from India.

A man upon finding his first born baby deformed created a ruckus in government women's hospital on Wednesday alleging that the administration had changed his baby after delivery. Dozens of villagers gathered in his support in the hospital and shouted slogans against the doctors. The man stated that he had twice got the sonography of his unborn baby done from a privated doctor who claimed that the baby was perfectly normal.

According to sources, Farhan of nearby Gagwana village, was very excited about his first child and he took his wife for sonography in her third and seventh months. "The doctor told me that the baby was perfectly alright and we were happy with it," said Farhan.

On Sunday, Farhan's wife delivered the baby in a government hospital and afterwards the baby was brought to the couple. "The child was deformed and we were shocked to see that. When I enquired the doctors, they said that the baby was born deformed," added Farhan.

Farhan again went to the same private doctor who had conducted the sonography of his wife, "The doctor claimed that it is not possible after looking at the sonography report that the baby would be born deformed," Farhan said.

Farhan on Wednesday came back to the hospital and returned the baby to the hospital administration demanding to return his real child, "They changed my baby with another and I demanded DNA test before taking the baby," said Farhan.

Dozens of villagers from Gagwana also gathered in the hospital and created ruckus. They shouted slogans against the hospital administration. Police was also called on the spot to control the situation.

Having a child with a birth defect is obviously difficult but when it's unexpected, it literally gut-wrenching for all concerned. At issue is the question: what are the reasonable expectations after an apparently normal 20 week scan?

In the Netherlands, Baardman et al reported on the introduction of a routine 20 week scan increased the detection rate for serious congenital heart defects. However, at best, 15% of the defects went undetected before birth.

Magriples and Copel analyzed a series of 901 patients who underwent ultrasound screening with referral for a targeted exam if an abnormality were suspected. The babies were then examined at birth. There were 28 abnormalities in total. Of these, 5 or 17.8% were missed. In general, the more severe were detected while some of those missed were more subtle.

So what's the take home message? Trying to perform a physical exam on someone who is inside someone else is often exceedingly difficult. Moreover, prenatally, the sonographer is not looking at the finished product.

As Yogi Berra once said in 1973, "It ain't over 'til it's over." To contact me or to schedule an ultrasound, call (718) 925-6277.