T&T: Babies with abnormalities now exceed 20

By Anna-Lisa Paul
As doctors remain focused on providing the best treatment and care for pregnant patients who have contracted the Zika virus, no thought has been spared as to the impact it is having on those in charge.

In a rare but candid and soul-baring interview, one of this country’s foremost public health authorities on obstetrics and gynaecology, Dr Karen Sohan, has provided an insight into the psychological and emotional effect the virus has wrought among those charged with the responsibility of ensuring the best treatment options are available to affected mothers and their unborn babies.

Dedicating the simply titled piece, The Psychological Impact of Zika, to the women she has been serving since March 31 when she was placed in charge of the Ministry of Health’s antenatal screening programme at the Mt Hope Women’s Hospital, Sohan shared another tidbit of exclusive information as she confirmed that the number of babies in which abnormalities believed to be caused as a result of the zika virus now exceeds 20.

She said, “For the pregnant women of this country, this has been a stressful period.”

Pointing to the overwhelming evidence that links the zika virus to abnormalities in the unborn baby, Sohan said, “Despite this, there were many couples who chose to continue their pregnancies. Their motivation was the overwhelming desire for a baby.”

Sohan, the Medical Chief of Staff of the Mount Hope Women’s Hospital, said the 373 women who received a total of 773 assessments were a select group—and apart from them having evidence of the Zika infection, “They all wanted their babies.”

She recounts, “Unlike the majority of ultrasounds performed at other times which were expected to be normal and therefore reassuring, in the case of my zika patients, there was always the fear that something would be wrong with the baby. The atmosphere was one of hope but there was always the threat that something sinister was lurking.”

Revealing that some patients had contracted the virus around the time of conception, while others were about to deliver, she said, “We shared information as everyone kept up-to-date with the evolving condition. It was a unique relationship for although I have been a doctor for 24 years, the doctor-patient interaction with this group was different.”

Controlled, well-informed and confident was how Sohan described her early introduction to the virus as she acknowledged that zika was a new pathology and that it would be a learning process.

“All seemed to be going well until September 5, when the 44th patient was being examined. No matter how I tried, I could not get the head measurements to correspond to the number of weeks pregnant. The head was measuring small.

“Further, as described in the international literature there was increased fluid around the brain and calcification of the cerebral cortex.

“An overwhelming sense of panic consumed me as I battled with the thoughts flying through my head. The 18 years of practising obstetric ultrasound at the highest standards allowed me to slip into autopilot and complete the examination.

“For the first time in my career, I was relieved that my back was to the patient and her husband. By now my cheeks and ears were flushed and my mouth was dry. In my head, I rehearsed how I was going to break the news to this couple. No words can describe the next few minutes as I looked into their eyes and informed them that their most-wished-for baby was indeed affected by the zika virus.

“The room was filled with such gloom and despair, the magnitude of which I had never experienced. Sadly, this scenario would play out several more times,” she tearfully related.

Admitting the scientist in her was initially fascinated, Sohan went on, “For the first time in history, a virus carried by a mosquito could harm the unborn baby and selectively affect the brain compared to other organs.

“Further, it only affected certain areas of the brain, especially those concerned with higher learning. And now, I could identify those changes on ultrasound. These were no longer images on the Internet or in journal articles but in real time that I could detect.”

Entering into a deep-seated conflict which she says is still ongoing, Sohan explained, “As I battled with my emotions, so did my pregnant women. They, too, were experiencing mixed emotions: fear, frustration and anger. Being with them became therapeutic as their expressions of gratitude for my work provided an unbelievable strength.

“ My heart was broken into a million pieces for the women whose babies were affected. Their sorrow was overwhelming.”

Pausing for a moment, Sohan quietly said, “Without a doubt, zika has humbled me. I have seen the beauty and ugliness of mankind, for during crisis situations there are those who give of themselves and others who use the calamity to promote themselves.”

Thanking her rock of support in the form of her husband Sterling and their children, Sanjeev, Sarika and Sanjili, Sohan also credited her sisters Michelle and Lindy for their unstinting support which she says sustains her both at home and in work, and house officer Dr Cathy Ann Cyrus, who has been a pillar of strength for her during the last seven and a half months. (Trinidad Guardian)

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