Prevalence and Spectrum of Fetal Congenital Anomalies: A Hospital Based Study from Mid-Western Part of Nepal

Abstract

Introduction: To estimate the prevalence and pattern of congenital anomalies through obstetric ultrasound on pregnant women visiting Rapti sub-regional hospital, Ghorahi, Dang, Nepal.
 Methods: A descriptive cross sectional study was conducted among 10,380 pregnant women visiting Radiology department of Rapti sub-regional hospital from January 2016 to July 2017. The findings of transabdominal ultrasonography (USG) performed by Radiologist and information regarding women’sage and gestational age were recorded. The images of any significant cases were also saved. Data wereanalyzed based on study objectives using descriptive statistics such as frequency, percentage, mean, rangeand standard deviation. The classification of the malformation was done based on the anatomical system.
 Results: Out of 10,380 ultrasound performed during the study period, 106 (1.02%) pregnant women presented with different congenital anomalies. The antenatal prevalence of congenital anomalies was 10.21 per 1000 pregnant women. The mean maternal age was 25.9 ± 4.80 years. Regarding gestation age, 87 (82.1%) anomalies were detected at second trimester of pregnancy. Most commonly involved body system was central nervous system 51 (48.1%), followed by cardiovascular system 12 (11.3%), musculoskeletal system 10 (9.4%), gastrointestinal system 5 (4.7%), respiratory system 5 (4.7%), genitourinary system 4 (3.8%). Other anomalies were cystic hygroma 9 (8.4%), hydrops fetalis 4 (3.8%), cleft lip 3 (2.8%), pelvic cystic lesion 2 (1.8%) and conjoined twins 1 (0.9%).
 Conclusion: The prevalence of congenital anomalies is high in mid-western part of Nepal. Central nervous system anomalies were more common than other anomalies.

Assessment of Diagnostic Value of 4D Ultrasound in Evaluation of Congenital Fetal Abdominal and Genitourinary Anomalies

“…In the present study, the anomalies were noted in the second trimester of gestational age. This agreed with Khanal et al, [39] who found that as regards the gestational age, 11 (10.4%) anomalies were detected at first trimester, 87 (82.1%) in the second trimester and 8 (7.5%) in the third trimester of pregnancy.…”

Study of Spectrum of Congenital Anomalies at Tertiary Care Hospital

“…Mean maternal age is 23.84 years which is inconsistent with other observations. 8 Congenital anomalies have multifactorial etiology, asserting a single cause is difficult. In this study multigravidas (73%), illiteracy (33.3%), and low socioeconomic status (57.1%) were found to have a greater association.…”

Evaluation of prenatal central nervous system anomalies: obstetric management, fetal outcomes and chromosome abnormalities

“…In the present study, the survival rate was only 49.82% due to the high rate of TOP and in-utero demise, and major portions of the surviving children were moderately or severely disabled. With advanced development in Fetal Medicine, more structurally abnormal fetuses could survive but they are at risk of morbidity throughout their life which greatly impact their families, healthcare systems as well as societies [ 1 , 2 , 4 , 19 , 21 ]. Primary prevention plays a big role especially in the reduction of the incidence of neural tube defect [ 3 , 7 , 8 , 20 , 61 ], and secondary prevention by routine USG examination to all pregnant patients should remain the mainstay of obstetrical screening [ 1 , 3 , 8 , 40 ].…”

“…Most of the time ultrasound (USG) screening provides reassurance to the couples, however, less than 5% of the scans revealed otherwise [ 4 , 5 , 17 – 19 ] CNS anomalies accounts for the highest percentage of prenatally detected deformities among all organ systems [ 3 , 4 , 11 , 13 , 20 , 21 ], with an incidence of 2-10 per 1000 live births [ 22 – 25 ]. With the advancement in imaging technologies offering a better resolution of the fetal cerebral structures and enhancement in the skill of sonographers, the detection rate was expected to rise [ 14 , 16 , 26 , 27 ].…”