Journal of Postgraduate Medicine
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Year : 1986  |  Volume : 32  |  Issue : 4  |  Page : 203-5  

Gynaecological and obstetrical survey of Bhopal women following exposure to methyl isocyanate.

NP Shilotri, MY Raval, IN Hinduja 
 

Correspondence Address:
N P Shilotri





How to cite this article:
Shilotri N P, Raval M Y, Hinduja I N. Gynaecological and obstetrical survey of Bhopal women following exposure to methyl isocyanate. J Postgrad Med 1986;32:203-5


How to cite this URL:
Shilotri N P, Raval M Y, Hinduja I N. Gynaecological and obstetrical survey of Bhopal women following exposure to methyl isocyanate. J Postgrad Med [serial online] 1986 [cited 2017 Nov 22 ];32:203-5
Available from: http://www.jpgmonline.com/text.asp?1986/32/4/203/5323


Full Text



 INTRODUCTION



The leakage of methyl isocyanate gas (MIC) from an industrial reservoir at Bhopal on 2nd and 3rd December 1984 led to widespread mortality and morbidity. A medical survey[1] was carried out 105 days later to assess the residual effect of MIC on the population staying near the reservoir. The present paper describes the effect of MIC seen in the women population of childbearing age-group.

 MATERIAL AND METHODS



Two groups of subjects were studied as described earlier. In Group I, there were 160 females of child bearing age group; out of them 88 females had gynaecological complaints and they were referred to us. In Group II, out of 38 females in child bearing age group, only 12 were symptomatic and therefore included in this study.

A detailed history of gynaecological symptoms was taken from each female under study. History of recent obstetric loss was asked for in all subjects who were known to be pregnant at the time of gas leakage. External and internal examination was carried out in each subject and cervical smears were obtained in cases who had excessive vaginal discharge without clinically detectable local infection or pelvic factor.

 RESULTS



The chief complaints and examination findings are shown in [Table 1]. Symptoms had followed the gas tragedy. There was no history of itching, burning or foul smelling discharge.

[Table 2] shows the results of cervical smear examination in 39 Group I cases who had excessive vaginal discharge without obvious local infection and pelvic factor accountable. Since the local examination revealed healthy vagina and cervix, it is a matter of conjecture whether this could be chemical inflammatory response evoked by exposure to MIC.

[Table 3] shows results of obstetrical examination. Seven patients who had sub optimal uterine height, did not show clinically any evidence of severe anaemia, toxaemia or gross malnutrition explaining intra-uterine growth retardation (IUGR). However, they complained of reduce movement but there was no foetal death. Twenty-nine out of 38 cases who were known to be pregnant during gas leak gave history of first and second trimester abortion soon after the tragedy. However, the date as to the onset and aftermath of abortion process was not available in details, as the episode of abortion followed a period of unconsciousness in many cases.

At the time of reporting 2 patients front the series had delivered pre-term babies with spina bifida, meningo-myeleocele, limb deformities and signs of heart disease. Both the babies died soon after birth. On autopsy, both showed lungs that were enlarged, solid, heavy and showed fibronodular deposit, bilaterally. They also showed liver and brain damage. These mothers were exposed to MIC during 10 to 12 weeks of gestation.

To detect the cause of IUGR, presence of congenital anomalies and neurological defects, ultrasound examination and amniocentesis were planned but could not be carried out due to non-compliance of the patients.

 DISCUSSION



The above study reveals the long term effects of MIC from 100-115 days after the disaster. The findings speak for themselves. The possibility of inflicting congenital malformations in a new born is expected to be high due to:

1. high levels of MIC in blood during conception phase and organogenesis.

2. anoxia produced due to acute cyanide poisoning.

3. sensitive time of development of neurological system.

It is strongly suggested that all antenatal patients should be under careful surveillance and should have institutional deliveries to detect the trend in occurrence of congenital malformations and to note the exact incidence of the same.

The frequent occurrence of inflammatory smear and dysplasia calls for periodic follow up of these patients in view of possibility of development of carcinoma in future.

 ACKNOWLEDGEMENT



We thank the organisers, the Dean, K.E.M. Hospital and Municipal Administrators for giving us the opportunity to & the survey and publish the data.

References

1Naik, S. R., Acharya, Vidya N., Bhalerao, R. A., Kowli, S. S., Nazareth, H., Mahashur, A. A., Shah, S., Potnis, A. V. and Mehta, Arundhati, C.: Medical Survey of methyl isocyanate gas affected population of Bhopal. Part I-General medical observations 15 weeks following exposure. J. Postgrad. Med., 32: 175-184. 1986.

 
Wednesday, November 22, 2017
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