Dear Aunt Silvia,

I want to thank you for the advice that you always give to us readers. I am a married woman and a mother of two children. My youngest daughter was born with a disease called hydrocephalus.

Even though she is almost one year old she is yet to sit because of the volume of her head. I want to have another baby but am afraid of getting a baby with the same condition.

Is it true that doctors can detect hydrocephalus when a woman is still pregnant? And if so, is it allowed on medical grounds to terminate such a pregnancy? Please help me.
Jane.

Dear Jane,

Hydrocephalus occurs due to abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. Most often this is because of an obstruction preventing proper fluid drainage.

The excess fluid can push fragile brain tissues up against the skull — causing brain damage and, if left untreated, even death. Once known as "water on the brain,” hydrocephalus is sometimes present at birth, although it may develop later.

About one out of 500 children are born with the disorder. The outlook for people with hydrocephalus depends on how quickly the condition is diagnosed and whether any underlying disorders are present.

To answer your question; yes, your doctor may diagnose congenital hydrocephalus in your unborn child during a routine prenatal ultrasound.

The condition may also be discovered during infancy or early childhood, when the head is regularly measured as part of growth monitoring.

If your baby’s head is visibly enlarged or its growth over time is more rapid than that of other infants, your doctor may recommend an ultrasound of the head. If the results of the ultrasound are abnormal, your infant will need further evaluation.

I understand your worry, but please know that just because one child has this condition does not mean that the ones that you will have later will have the same condition. It however is advised that you go for a thorough check up before you try for another baby.

Also be informed that usually, hydrocephalus does not cause any intellectual disability if recognized and properly treated. In the meantime since your child needs special medical care, I would advise you to concentrate on her needs.

Before you think of another child, make sure proper treatment is being administered until when your daughter is ready to go to school and can be independent on her own.

Otherwise you will be torn between a new born baby and an infant with very special needs, the end result being failure to adequately take care of both.

Last but not least consult your doctor about the laws of the country, if a foetus can be terminated in such cases. Otherwise as far as Rwanda is concerned, abortion is illegal and doctors who are known to perform abortions usually face a very harsh punishment.

Contact: kayitesius@yahoo.com