Screening for congenital fetal anomalies in low risk pregnancy: the Kenyatta National Hospital experience

Abstract

BackgroundCongenital malformations contribute significantly to the disease burden among children globally. A study conducted in Kenya on understanding the burden of surgical congenital anomalies, highlights the need for Kenyan health systems to go beyond the medical dimensions of illness. This could be achieved by linking knowledge of the severe congenital anomalies (CAs) and their impact of varying disability to the delivery of local health services and public health program planning. Subsequently, early detection of these congenital anomalies is vital and can be achieved through fetal ultrasonography.Studies have proven that antenatal ultrasound can successfully diagnose fetal abnormalities in many cases and therefore aid in counseling of parents and planning for early intervention.Although there are studies on screening of congenital anomalies in various populations, very few have been done in the African population and none to the best of our knowledge has been done in Kenya.MethodsThe patients, who underwent routine obstetric ultrasounds, were recruited into the study. The study population comprised patients who were referred from the obstetric clinic, casualty and other clinics within the hospital vicinity. Data of antenatal ultrasounds was statistically analyzed on structured data collection form to determine the prevalence of congenital anomalies.ResultsFifteen fetal anomalies were diagnosed in 500 women who came for routine ultrasound (3%). The mean age of the mothers was 28.2 years (SD ± 4.5) with an age range from 15 to 44 years. 400 (80%) of the mothers were aged between 27 and 34 years.The most frequently observed fetal anomalies involved the head (8/ 500; 1.6%). Each of the remaining anomalies affected less than 1% of the fetuses and included anomalies of the spine (2/ 500; 0.4%), pulmonary (2/ 500; 0.4%), renal and urinary tract (2/ 500; 0.4%) and skeletal systems (2/ 500; 0.4%). Majority, 9 of 15 (60%) of the fetuses with anomalies detected on prenatal ultrasound resulted in postnatal mortality within days of delivery.ConclusionCongenital anomalies prevalence in our setting compares with those found in other studies. From this study, major birth defects are a major cause of perinatal mortality.

Prevalence of congenital malformations at the “les Orangers” maternity and reproductive health Hospital of Rabat: descriptive study of 470 anomalies

“…This delay in antenatal diagnosis of congenital malformations is also reported in other studies covering developing countries with, for example, a median gestational age of 31 weeks in Saudi Arabia and 32 weeks in Kenya [31,32].…”

Prevalence of congenital anomalies in Sudanese fetuses: A prospective study

“…The prevalence of CAs seems to be varied; Sunitha et al (2017) suggested that eleven percent were pregnant women carrying fetuses with CAs. Onyambu and Tharamba (2018) showed that the prevalence of CAs through routine U/S was 3%. Ukweh et al (2019) concluded that anomaly prevalence is 1.67%.…”

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

“…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 ].…”