Birth defects on the rise

Birth defects are becoming more common of recent. Doctors advise planned pregnancies and early check up to control them.

Thirty-five-year-old, Pascal Nabakooza, calmly sits by her three weeks old baby, Angelina’s bed awaiting news of when her operation will be done.

Baby Angelina was born at Mulago Hospital with a cranium bifidum defect, a condition where a child is born with sac-like protrusions usually on the back of the head.

“If you knock the swelling by mistake she cries, I think it hurts,” Nabakooza says.

She keeps on caressing the baby and when I tell her that her baby is cute, she is quick to say that I am only saying that out of sympathy.

“I saw the defect for the first time when she was born. I was surprised I didn’t expect to see anything like that,” she says.

According to Dr Michael Muhumuza, the Acting Head of the Neurosurgical unit at Mulago Hospital, these conditions called congenital anomalies are increasingly becoming common, with neural tube defects (NTDs) the commonest at Mulago Hospital.

NTDs are birth defects of the brain and spinal cord which occur during the first one month of fertilisation or conception just like the other congenital anomalies.

“When the process of forming the neural tube goes wrong (when the structure that develops into the brain and spinal cord, fails to close completely) it results into defects in the brain, skull, spinal cord and vertebrae,” says Dr Muhumuza. Data from the neurosurgical unit of Mulago Hospital shows that about seven to 10 babies are born every week with this condition at this hospital alone. The commonest NTDs occurring, Dr Muhumuza says, include; spina bifida which presents with a sac-like protrusion on the lower back of the baby, cranium bifidum which is a sac-like protrusions usually on the back of the head, and hydrocephalus which is a big head among others.

Babies with these defects can only be born by caesarean and although surgeries are done to close off these defects, Dr Muhumuza says, depending on the location and severity of the abnormality, babies usually suffer life-long irreversible disability like paralysis of the legs, inability to control urine or stool, intellectual disability, vision problems and seizures.

“The most unfortunate thing is that most people know that they are pregnant after one month when they miss their periods and if any problem has happened, it is too late to reverse it,” says Dr Muhumuza.

Plan pregnancies
“So it important to plan for a pregnancy so that one can start taking foods rich in folic acid or tablets at least one month before pregnancy and during pregnancy,” he says. “Also important is to educate the masses to plan for their pregnancies. Folic acid is quite a cheap vitamin but you might find that the people do not know that they need to feed on them.”

Folic acid is a vitamin abundant in green vegetables. It is also found in liver and fruits. Although many women do take these vital vitamins during pregnancy, it may not be of great help if these foods were not taken within the first 28 days of pregnancy. Dr Muhumuza also advises pregnant mothers to have three dimensional scans which can clearly show how a foetus looks. This, he says, can help doctors advise couples accordingly as at times, the foetus is severely deformed and the babies may not be able to survive.

The issue of planning families however remains a big challenge in Uganda, a society where people still prefer to have many children and women are not empowered to negotiate for the number of children to have and when.

Nabakooza, for instance, says she got pregnant while still breastfeeding the baby before Angelina, as her husband would not allow her to use any family planning methods. Dr Muhumuza says there is urgent need to educate women in the child bearing age about planning pregnancies to avert these cases.

flanyero@ug.nationmedia.com