Publication:

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

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.