Pohlner, who along with Dr Mark Coulthard, was in Chennai and operated upon 16 cases at the Southern Railway Headquarters Hospital, Perambur, said in Europe and Australia, doctors have been advocating termination of pregnancies in cases where the child in the womb is detected having complicated congenital heart disease. In Europe, nearly 18 per cent cases of pregnancy in which the child in the womb has been detected to have congenital heart disease have been terminated.

Admitting that terminating pregnancy is definitely controversial, the doctors said even in Australia, termination of pregnancies in such cases was uncommon. One has to see the better side, especially when there are major abnormalities. `These teenagers with congenital heart disease will not survive old age. However,it should be the parents' decision.'

The doctors, who were in Chennai for two weeks, said India had to come a long way in identifying the problem. Pohlner has come on this exchange programme for the fourth year at the Perambur Railway Hospital said there was a marked improvement in the surgeries being performed at the hospital. He said with some minor adjustments and better equipment, things could improve more. He was confident that improvements could be achieved by the Railway doctors in the next one year. Mark added, `We have discussed the changes required with the doctors.'

The surgical staff are highly skilled. The Railway Hospital has an excellent cardiology team, cardiac surgery team and cardiac anaesthetists team. However, there are some limitations in the drugs available.