Congenital Malformation - A Biological Accident (A 6 years 9 months study in a rural based tertiary care hospital)

Congenital Malformation - A Biological Accident

Abstract

Background: Birth of live congenitally abnormal child especially at term is a great mental and social trauma to parents, family and to the society. In developed countries it is one of the main causes of infant mortality. It accounts 8-15% of peri-natal deaths and 13-16% of neonatal deaths in India. Aims & Objectives : To find out the incidence of congenital anomalies in live and still births and to find out association of major and minor anomalies to maternal demographic profile and to various obstetrics and medical parameters.
Materials & Methods: This study was carried on rural based tertiary care referral hospital. All the deliveries occurred during 1st September 2004 to 30th June 2011 (81months) comprised 7053 births were enrolled. The new born were examined systematically by obstetrician and pediatrician. System wise distribution of anomalies and correlation with risk factors were analyzed. Results: Out of total 7053 deliveries, 6433 were live births and 620 were still births. Total number of congenital malformed babies were 71 (1.006%). 31 (43.66%) of the 71 malformed babies were still born and 27 (38.02%) were NND (neonatal death). It means out of 100 stillborn, 43 babies had structural malformation. Major malformation was present in 58 and minor anomalies were present in 13 fetus. Marginal Male predominance 40 (56.33 %) was noted. Central nervous system malformation was most common in live births followed by respiratory system and musculo skeletal system. 64% patients had not taken ANC (antenatal care) and in them 92% had major anomalies. 81.3% anomalies were detected by 2nd trimester USG (ultra sonography) and 18% anomalies were not detected by USG out of which 98% were minor anomalies. Conclusion: Congenital anomalies are a major cause of still births and infant mortality. Regular ANC, 2nd trimester USG for early detection and folic acid supplementation for prevention are the important factors to be considered to decrease the burden of congenital malformation.