Manivannan, N (2010) Incidence of congenital anomalies in newborn in tertiary care hospital. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
INTRODUCTION: Just about three decade ago (1976) congenital malformations comprised 8 % of perinatal deaths, from available data and ranked fifth as a cause of perinatal mortality. But the trend is rapidly changing over years. In a recent study from AIIMS, Delhi congenital malformations contributed to 15.7 % of perinatal deaths and ranked fourth as cause of perinatal deaths. In another study from Hyderabad 17.8 % of perinatal death were due to congenital malformation, being the second commonest cause. This changing trend over years warns us that with the control of nutritional and infections diseases, congenital malformations will come to the forefront as it is in the West now. Therefore a systematic study of congenital malformations in live and still births is of paramount importance to evaluate etiological agents, to undertake preventive steps, to intervene early in the treatment of life threatening malformation at birth and thus reducing perinatal mortality due to them. AIMS OF THE STUDY 1. To find out the incidence of congenital anomalies in a 1 year period of 5000, consecutive births delivered at GMKMCH, Salem. 2. To find out the prevalent types of congenital anomalies. 3. To find out the contribution of consanguinity in the occurrence of congenital malformations. 4. To find out prevalence of malformations in relation to the gestation and sex of the babies. 5. To find out the incidence of congenital anomalies in still birth. 6. To find out the probable aetiology of congenital anomalies. MATERIALS AND METHODS: The study was conducted at Government Mohan Kumaramangalam Medical College Hospital, Salem. Five Thousand babies born of consecutive deliveries were taken for the study, over the period of one year. All mothers were interrogated within 48 Hours of delivery as per the proforma prepared, which contains the following particulars like, maternal and paternal age, consanguinity, detailed antenatal history with reference to exposure to teratogens especially during 1st Trimester and medical disease complicating pregnancy like Diabetes, Rheumatic heart disease, Hypertension, detailed obstetric history with reference to previous abortions and still birth. Routine investigations like haemoglobin, urine analysis, blood grouping and Rh typing, VDRL, and HIV were done for all cases and blood sugar, renal function and liver function tests were done when indicated for mothers. Every newborn was subjected to detailed examination from head to toe within 48 hours of birth. Assessment of the newborn included birth weight, sex, live born/still born, gestational age and details of congenital malformations. All were recorded in a pre designed proforma. A gavage tube was used to check choanal and oesophageal atresia, Anorectal anomaly in suspected cases. All the newborns were followed up every day till the time of discharge from the hospital. Necessary investigations were done wherever required. Cardiovascular anomalies were subjected to ECG, X ray chest AP view and ECHO cardiography. The umbilical cord stump was examined to note down the anomalies of arteries and vein. Placenta was examined in Detail. OBSERVATIONS: Of the five thousand consecutive deliveries 48 deliveries were multiple delivers and number of still births were 108. The incidence of congenital anomalies, was 30.4 per 1000 live birth (152 cases). Major malformations were present in 20.8 per 1000(104 cases) while minor malformations were 9.6 per 1000 (48 cases). SUMMARY AND CONCLUSION: 1. Incidence of congenital malformations in the present study is 30.4 per 1000 live births, of which major malformations were 20.8 per 1000 and minor malformations were 9.6 per 1000. 2. The most common system involved in the study is Central Nervous System (5.6 per 1000). 3. The second commonest system involved in the present study is GIT (4.6 per 1000). 4. The incidence of malformations were marginally higher in babies born to mothers over the age of 35 years and mothers with parity 4 and above 5.46% and 14% respectively. 5. Congenital malformations especially neural tube defects were common in babies born of second degree consanguineous marriage. (Significant contribution of second degree consanguinity was noted in all major malformations 38.81%). 6. The incidence of malformations were higher in cases with complications of pregnancy like diabetes 33.33% and hydramnios31.81% and PIH 6.52%. 7. Incidence of malformation were higher in preterm babies 6.31%. 8. Incidence of malformations were higher in male babies, especially genitourinary system anomalies. 9. Incidence of malformations were higher in still born babies and in twins 10.18% and 8.33% respectively. 10. Antenatal events in the 1st trimester like fever, drug intake could be implicated in aetiology of malformations especially neural tube defects in our study. 11. Prenatal diagnosis using ultrasound is accurate, but performed late. So, a high index of suspicion and early scanning in high risk mothers are necessary.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Incidence ; congenital anomalies ; newborn ; tertiary care hospital. |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Jun 2018 01:03 |
| Last Modified: | 11 Jun 2018 01:03 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8373 |
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