Recent amendments to the MTP Act, 1971 permit termination of pregnancy beyond 24 weeks in case of substantial foetal abnormalities, and the Court's decision is based on the interpretation of the MTP Act, 1971 and settled legal position in various judgments.

JUDGMENT

Prathiba M. Singh, J. - This hearing has been done through hybrid mode (physical and virtual hearing).

2. The present petition has been filed by the Petitioner, seeking permission for medical termination of her pregnancy. The Petitioner has invoked the provisions of the Medical Termination of Pregnancy Act, 1971 (hereinafter referred to as MTP Act, 1971 ). The submission of ld. counsel for the Petitioner is that the Petitioner's foetus is more than 24 weeks in age, however, she should be permitted to carry out the termination in view of the abnormalities of the foetus and the risk involved for the Petitioner who is suffering from severe heard conditions.

3. Vide order dated 26th March, 2021, this Court had directed the Medical Superintendent of AIIMS to appoint a Board of Doctors to examine the Petitioner. The said Board of Directors consisted of a Chairperson and seven Members, along with a Member Secretary. The Medical Board was chaired by the Professor, Department of Obstetrics & Gynaecology and the Members are from various departments i.e., Department of Paediatrics, Department of Radio-diagnosis and Department of Cardiology, etc. A report was to be submitted by the said Board after examination of the Petitioner. The report has now been received by this Court. The opinion of the Medical Board clearly is as under:

"Opinion:

The petition is a known case of heart disease since 2018 and was on blood thinners following MVR done in March 2019. Presently she is pregnant for the second time and is at the 25th week + 4 days POG by LMP and 25 weeks + 3 days by ultrasound Scan. the report of the ultrasoundgraphy done at AIIMS has been attached. The Medical board has noted the following points:

The fetus has warfarin embryopathy which has a guarded prognosis in terms of immediate and long term outcomes especially in view of the intracranial bleeds and ventriculomegaly. As the fetus may be viable at birth, if the termination is planned feticide with intracardiac KCI is advisable before MTP.

The mother in a known case of cardiac disease with MVR done in 2019 on warfarin 5mg/6mg.

The procedure of termination of pregnancy at this stage will involve switch over to heparin with use of prostaglandins, which increase the risk of maternal cardiac failure. It may be a long drawn process with a subsequent need for hysterotomy (surgical procedure).

The patient has been evaluated clinically by the cardiologist at AIIMS and also an echocardiogram has been performed. According to his opinion the patient has permissible cardiac risk for the procedure.

In view of the above observations, the patient may undergo the procedure, provided they understand the maternal risk of cardiac failure and prosthetic valve complication.

4. A perusal of the Medical Board s opinion clearly shows that the Petitioner i.e., the mother, is a known cardiac patient who has been administered blood thinners including warfarin 5mg/6mg. The Medical Board s opinion is that in view of the said blood thinner administered to the Petitioner, the foetus has warfarin embryopathy which has a guarded prognosis in terms of immediate and long term outcomes especially in view of the intracranial bleeds and ventriculomegaly.

5. The foetus is clearly more than 25 weeks in age. The opinion of the Medical Board is that the termination of the pregnancy would involve some risk to the patient, but the said risk is within the permissible limit for cardiac patients and is a risk which could be undertaken.

6. Ms. Mukherjee, ld. Counsel appearing for the Petitioner relies upon the provisions of the recent amendments to the MTP Act, 1971, as contained in the Amendment Act, 2021 to argue that the said amendment in fact permits medical termination of pregnancy without any limitation of age, if there are any substantial foetal abnormalities.

7. Dr. P. Kumar has appeared before this Court on behalf of AIIMS and he submits that there is a certain amount of risk in the medical termination of pregnancy given the