Karnataka High Court
Smt Priya P vs The State Of Karnataka on 28 January, 2025
Author: R Devdas
Bench: R Devdas
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NC: 2025:KHC:3828
WP No. 2078 of 2025
IN THE HIGH COURT OF KARNATAKA AT BENGALURU
DATED THIS THE 28TH DAY OF JANUARY, 2025
BEFORE
THE HON'BLE MR JUSTICE R DEVDAS
WRIT PETITION NO. 2078 OF 2025 (GM-RES)
BETWEEN:
SMT PRIYA P
W/O K P SUHAS
AGED ABOUT 29 YEARS
R/A NO. 1413/A
SHANTHERIKAMAKSHINIVAS
14TH MAIN ROAD
MUNESHWARA BLOCK
BENGALURU 560 026
...PETITIONER
(BY SRI. HEGDE RAMAKRISHNA S., ADVOCATE)
AND:
Digitally signed by
KRISHNAPPA 1. THE STATE OF KARNATAKA
LAXMI YASHODA
Location: HIGH DEPARTMENT OF HEALTH AND FAMILY WELFARE
COURT OF VIKASA SOUDHA, BENGALURU 560 001
KARNATAKA
REPRESENTED BY ITS PRINCIPAL SECRETARY
2. THE BENGALURU MEDICAL COLLEGE
AND RESEARCH INSTITUTE
K R ROAD, FORT
BENGALURU 560 002
REP. BY ITS MEDICAL SUPERINTENDENT
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NC: 2025:KHC:3828
WP No. 2078 of 2025
3. THE UNION OF INDIA
DEPARTMENT OF HEALTH AND FAMILY WELFARE
ROOM NO. 211-D, NIRMAN BHAVAN
NEW DELHI 110 11
REPRESENTED BY ITS SECRETARY
4. VANI VILAS HOSPITAL
BANGALORE-560002
REP BY ITS MEDICAL SUPERINDENDANT
...RESPONDENTS
(BY SRI.SHAMANTH NAIK., HCGP FOR R1, R2 & R4
SRI. H. SHANTHI BHUSHAN H., DSGI FOR R3)
THIS W.P. IS FILED UNDER ARTICLES 226 & 227 OF THE
CONSTITUTION OF INDIA PRAYING TO PERMITTING THE
PETITIONER TO UNDERGO FOR FOETAL EUTHANASIA AND
TERMINATION OF THE 35 WEEKS PREGNANCY UNDER THE
MEDICAL CARE AND SUPERVISION OF DR. SAVITA SRIKANTH
SHIRODKAR, RANGADORE MEMORIAL HOSPITAL,
SHANKARAPURAM, BASAVANAGUDI, BENGALURU AS EARLY AS
POSSIBLE.
THIS PETITION, COMING ON FOR ORDERS, THIS DAY,
ORDER WAS MADE THEREIN AS UNDER:
CORAM: HON'BLE MR JUSTICE R DEVDAS
ORAL ORDER
The petitioner is before this Court seeking the following prayers:
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NC: 2025:KHC:3828 WP No. 2078 of 2025
a) Permitting the petitioner to undergo for foetal euthanasia and termination of the 35 weeks pregnancy under the medical care and supervision of Dr. Savita Srikanth Shirodkar, Rangadore Memorial Hospital, Shankarapuram, Basavanagudi, Bengaluru as early as possible.
b) May pass any orders as this Hon'ble Court feels fit and proper under the facts and circumstances of the case, in the interest of justice and equity.
2. On the previous occasion, when the matter had come up before this Court, this Court recorded the submission made by the learned counsel for the petitioner that the petitioner who is about 29 years old is pregnant for the second time. The living foetus is about 35 weeks now. Learned counsel submitted that recently when the petitioner was examined, it was found that the foetus has been diagnosed with Bilateral Intracerebral Hemorrhage, Grade III and it has been advised that the petitioner should terminate the pregnancy.
3. Having regard to the provisions contained in the Medical Termination of Pregnancy Act, 1971, the Medical Board was required to be constituted to obtain an experts opinion regarding termination of the pregnancy of the -4- NC: 2025:KHC:3828 WP No. 2078 of 2025 petitioner. Accordingly, directions were issued by this Court to constitute the Medical Board. Accordingly, respondent No.4-Vanivilas Hospital, represented by its Medical Superintendent was hereby directed to constitute the Medical Board and examine the petitioner on 27.01.2025 and the report with the medical opinion of the Medical Board shall be furnished to this Court on 28.01.2025.
4. Accordingly, a report of the Medical Board has been furnished to this Court in a sealed cover. The opinion of the Medical Board dated 28.01.2025 reads as follows:
"Medical Board Opinion for the Termination of Pregnancy of Mrs. Priya P Name: Mrs Priya P w/o K P Suhas Age: 29 years UHID - 20250501644 Address: Kizhkkeparambil, Pottammal, Kuthiravattam, Kozhikode, Kerala Date, time and place of examination:
27/01/2025, 01:00PM, Vani Vilas Hospital, BMCRI, Bengaluru -5- NC: 2025:KHC:3828 WP No. 2078 of 2025 Case examined by -Medical Board as per the instructions by the Hon. High court of Karnataka, Bangalore, for the writ petition No 2078/2025 dt. 27.01.2025 HISTORY LMP: 19/05/2024 EDD:26/02/2025 EDD by scan: 20/05/2025(5weeks and 4 days as per scan) G2P1L1 with 35+5 weeks Period of gestation K/C/O Chronic Hypertension since 3 months of pregnancy on Tab.Labetalol200mg BD. No history of any comorbidities like DM, thyroid/ heart diseases, epilepsy, etc. Patient is on Tab. Aspirin 150mg OD X 4 months of amenorrhea.
PHYSICAL EXAMINATION Patient is alert, conscious and cooperative. Build and nutrition: Moderate Weight: 62kgs Height: 162 cms No pallor, no pedal edema, no cyanosis Thyroid, breast, spine are normal.
Pulse: 72bpm BP: 106/76 mm Hg Respiratory rate: 16cpm -6- NC: 2025:KHC:3828 WP No. 2078 of 2025 Cardiovascular system: S1, S2 heard, clinically no abnormality detected Respiratory system: clinically no abnormality detected OBSTETRIC EXAMINATION On examination:
Per abdomen: Uterus 34 weeks sized, Relaxed,Breech presentation, Foetal heart sounds heard FHS -146 BPM IMPRESSION :
G2P1L1 with 35+5 weeks with Chronic Hypertension with breech presentation with grade IV Intracerebral Bleed in foetus for Termination of Pregnancy.
Investigations:
Hb- 11.5gm% Platelets: 1.11 lakh/mm3 WBC: 10,700 cells/ cm TSH: 2.04ml0/mL Blood glucose: 60.7mg /di Blood group: O positive HBsAg- Non reactive VDRL- Non reactive HIV - Non reactive Renal Function Tests: Within Normal Limits Liver Function Tests: Within Normal Limits -7- NC: 2025:KHC:3828 WP No. 2078 of 2025 ECG - Within Normal Limits Urine albuin: nil PT - 15.1 sec APTT- 28.9 sec INR- 0.99 ULTRASOUND FINDINGS Ultrasound examination of abdomen on 27/01/2025 Single live intrauterine gestation noted with the following parameters:
Presentation: BREECH Foetal heart rate: 142 bpm Biparietal Diameter: 9.13 CM Head circumference: 32.29 CM Abdominal circumference: 29.77 cm Femur length: 6.83 cm Mean gestational age: 35+5 weeks + 3 weeks Estimated foetal weight:2500 grams Placentaanterior, lower margin well above the internal os Amniotic fluid volume- adequate, AFI 5cm.
Umbilical artery shows normal diastolic flow. Right lateral ventricle at frontal horn measures 1.24cm and at atrium measures 3.25cm - dilated Left lateral ventricle at frontal horn measures 1.19cm and at atrium measures 2.97cm - dilated.-8-
NC: 2025:KHC:3828 WP No. 2078 of 2025 3rd ventricle measures - 4.6mm normal. E/o a well-defined heterogenous hypochoic content with hyperechoic rim, measuring 4.3x1.4cm noted within body and frontal horn of right lateral ventricle - likely intraventricular haemorrhage. E/o a well-defined heterogenous hypochoic content with hyperechoic rim, measuring 3x1.3cm noted within body and frontal horn of left lateral ventricle - likely intraventricular haemorrhage.
Similar hypochoic content noted in 3rd and 4th ventricle.
IMPRESSION:
SINGLE LIVE INTRAUTERINE GESTATION OF 35+5 WEEKS +/- 3 WEEKS GROWTH BY SCAN WITH BREECH PRESENTATION, DILATED LATERAL VENTRICLES AND INTRAVENTRICULAR HEMORRHAGE AS DESCRIBED.
MRI FINDINGS:
Right grade 4 intracerebral haemorrhage with large intraventricular clots and small caudothalamic groove and adjacent cerebral hemorrhages.-9-
NC: 2025:KHC:3828 WP No. 2078 of 2025 Gross dilation of lateral ventricles with mild dilatation of third ventricle and mild midline shift to left.
Left anterior temporal arachnoid cyst with mild mass effect.
RADIOLOGY OPINION:
Further continuation of pregnancy may lead to increased perinatal complications as well as poor neurodevelopment outcome in the baby. Hence patient can be taken up for Termination of Pregnancy.
ANAESTHESIA OPINION:
Case is accepted under ASA grade 2.
DEVELOPMENTAL PEADIATRICIAN OPINION:
1. It is a viable foetus.
2. Possibility of IUD, perinatal complication, if foetus survives neurodevelopmental outcome in poor and requires NICU care with life support.
3. Timing and mode of delivery as per obstetric indication only with safe guarding the mother.
The above factor has been counselled to the parents.
Patients can opt for early intervention only through Writ petition to the court and later they can only request for passive euthenesia.
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NC: 2025:KHC:3828 WP No. 2078 of 2025 PSYCHIARTY OPINION:
No active psychopathology, IQ of the mother is normal. Diagnosis Psychiatrically NIL.
Counselled the patient and husband for medical reason of Termination of Pregnancy. No contraindication from psychiatry side for the procedure.
FINAL OPINION of the medical Board:
G2P1L1 with 35+5 weeks of gestation with Chronic Hypertension and breech presentation withfetal dilated lateral ventricles and Grade IV interventricular hemorrhage and large intraventricular clots for Termination of Pregnancy.
The word Fetal Euthanasia is incorrect, as the word euthanasia is used for the painless death of a person who is born, and can be used only for a person who is born. As the writ petition has used the word FETAL EUTHANASIA, this raises the issue whether the unborn child has legal fundamental right to live, therefore the board suggests that the word FETAL EUTHANASIA should be corrected to TERMINATION OF PREGNANCY else it can lead
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NC: 2025:KHC:3828 WP No. 2078 of 2025 to further unnecessary interpretation of the word FETAL EUTHANASIA.
After consideration of the antenatal scans and fetal MRI, the MEDICAL BOARD is of the opinion that, if the fetus survives the neurodevelopmental outcome is certainly very poor, however, the exact extent of the neurodevelopmental disabilities can only be determined after the child is born. Therefore, considering the mental trauma to the parents and the probable neurodevelopmental disabilities of the fetus after birth, the termination of the pregnancy may be considered."
5. In the light of the afore-quoted opinion of the Medical Board, the victim can undergo termination of pregnancy with necessary precautions and it would become necessary for a direction to be issued to the Hospital to undertake termination of pregnancy. Therefore, the following:
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NC: 2025:KHC:3828 WP No. 2078 of 2025 ORDER
1. The writ petition is disposed of.
2. Mandamus issues to respondent No.4 - Hospital is directed to carryout the procedure for Medical Termination of Pregnancy in terms of the Medical Termination of Pregnancy Rules, 1971, forthwith at its hospital at the cost of the State.
3. The procedure is subject to further examination of the Doctor who has to conduct such a procedure and if in the opinion of the Doctor, such a procedure would cause harm or injury to the life of the petitioner, the Doctor shall be the final deciding authority as to whether to go ahead or not with such a procedure;
4. The petitioner shall not be liable to make payment of any amounts towards such procedure.
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NC: 2025:KHC:3828 WP No. 2078 of 2025
5. A copy of this order shall be furnished to learned Additional Government Advocate.
6. Registry shall communicate this order to the Hospital - the Medical Superintendent of Vani Vilas Hospital forthwith, by way of electronic mail.
Sd/-
(R DEVDAS) JUDGE JT/-
CT: JL