Study of congenital fetal malformations among antenatal women in a tertiary care centre

Authors

  • Vibha Subhash More Department of Obstetrics and Gynaecology, Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial Hospital, Mumbai, Maharashtra, India
  • Annal Abhay Vaidya Department of Obstetrics and Gynaecology, Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial Hospital, Mumbai, Maharashtra, India
  • S. V. Parelkar Department of Paediatric Surgery, Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial Hospital, Mumbai, Maharashtra, India
  • Madhva Prasad Department of Obstetrics and Gynaecology, Seth Gordhandas Sunderdas Medical College and King Edward VII Memorial Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181344

Keywords:

Congenital malformations, Early recognition, Multidisciplinary approach

Abstract

Background: Congenital malformations are morphological or functional anomalies that occur in the prenatal period as a result of genetic mutation, chromosomal abnormalities and adverse intrauterine environment. Early recognition is important. If congenital malformations are detected beyond the period of legal limit for medical termination of pregnancy, it carries immense burden on the pregnant woman.

Methods: A descriptive observational study was conducted as a retrospective analysis of patient-records, over a span of 9 consecutive months in the Department of Obstetrics and Paediatric Surgery, at a tertiary care centre, Mumbai. The project was carried out to study demographic profiles, risk factors and system-wise distribution of pregnant women carrying malformed fetus.

Results: The average annual incidence rate was 29 per 1000 deliveries. Of 151 patients, renal malformations were the commonest accounted for 40% of all congenital malformations. This was followed by central nervous system 32%, cardiovascular 14%, gastrointestinal 8% and musculoskeletal 3%. Congenital malformations were more common in multigravida than primigravida. 92% of congenital malformations were detected beyond 20 weeks of gestation. Previous abortions, hypothyroidism and raised sugars were associated high risk factors.

Conclusions: The diagnosis of congenital malformation using ultrasonography occurs at a later gestational age than 20 weeks. For these patients a combined approach of the obstetrician/neonatologist/paediatric surgeon allows better counselling of parents and to permit preparation of the team to optimize neonatal outcomes.

References

WHO. Congenital anomalies. WHO Fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs370/en/

Gupta N, Kabra M, Kapoor S. Establishing national neonatal perinatal database and birth defects registry network - need of the hour! Indian Pediatr. 2014.51(9):693-6.

Bhide P, Gund P, Kar A. prevalence of congenital anomalies in an indian maternal cohort: healthcare, prevention, and surveillance implications. PLoS One. 2016;11(11):e0166408.

Kashyap N, Pradhan M, Singh N, Yadav S. Early detection of fetal malformation, a long distance yet to cover! present status and potential of first trimester ultrasonography in detection of fetal congenital malformation in a developing country: experience at a tertiary care centre in India. J Pregnancy. 2015;2015:623059.

Babu RS, Pasula S. Frequency of foetal anomalies in a tertiary care centre. J Clin Diagn Res. 2013;7(7):1276-9.

Savaskar SV, Mundada SK, Pathan AS, Gajbhiye SF. Study of various antenatal factors associated with congenital anomalies born at tertiary health centre. Int J Recent Trends Sci Techn. 2014;12(1):82-5.

Contia SL, Eisenberg ML. Paternal aging and increased risk of congenital disease, psychiatric disorders, and cancer. Asian J Androl. 2016;18(3):420-4.

Almeida L, Araujo Júnior E, Crott G, Okido M, Berezowski A, Duarte G, et al. Epidemiological risk factors and perinatal outcomes of congenital anomalies. Rev Bras Gynecol Obstet. 2016;38(7):348-55.

Agarwal A, Rattan KN, Dhiman A, Rattan A. Spectrum of congenital anomalies among surgical patients at a tertiary care centre over 4 years. Int J Pediatr. 2017;2017:4174573.

Glinianaia SV, Tennant PWG, Rankin J. Risk estimates of recurrent congenital anomalies in the UK: a population-based register study. BMC Med. 2017;15(1):20.

Rosano A, Botto LD, Botting B. Infant mortality and congenital anomalies from 1950 to 1994: an international perspective. J Epidemiol Comm Health. 2000;54:660-6.

Downloads

Published

2018-03-27

Issue

Section

Original Research Articles