CROSS-SECTIONAL STUDY OF NEED OF TARGETED USG AND ITS BENEFITS IN DECREASING FOETAL AND MATERNAL MORBIDITY AND MORTALITY BY OBSTETRIC DECISION MAKING IN A LOW RESOURCE SETTING
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 57
Abstract
BACKGROUND Congenital anomalies are responsible for a remarkable proportion of mortality and morbidity in newborns. This paper was focused on incidence of structural congenital malformations detectable at birth among 6380 deliveries. This study was conducted to evaluate the need for targeted USG and its benefits in decreasing foetal and maternal morbidity and mortality by obstetric decision making in a low resource setting by assessing structural congenital anomalies and to predict the variables which coexist in the incidence of congenital anomalies so that we can reduce the related perinatal morbidity and mortality. MATERIALS AND METHODS This is a cross-sectional study carried out in the Dept. of OB-GYN at Mahatma Gandhi Memorial Government Hospital attached to KAPV Government Medical College, Trichy during 10 months period from April 2016 to January 2017. A total of 6380 deliveries over 10 months, from April 2016 to January 2017, were studied for gross congenital malformations at birth as well as diagnosed antenatally by USG. All congenital anomaly cases detected at delivery were included in the study and also data from the birth register, and available medical & USG records during antenatal period were studied. RESULTS We diagnosed 104 cases of foetal anomalies. The antenatal prevalence of congenital anomalies was 1.63%. Out Of 6380 deliveries, 104 cases were identified with a primary diagnosis of congenital anomalies giving a prevalence rate of 1.63%. Anomalies of the cardiovascular system were the most common defects; accounting for 40.38% of birth defects followed by CNS anomalies of 25.0% & GIT anomalies of 18.27%. The surgery rate for delivery for anomaly group 19-22 weeks cases was 11.77%, which is very low when compared to 23-40 weeks anomaly group cases, where the surgery rate was 42.53%. Perinatal morbidity rate is 105.77% and mortality rate is 894.23% in anomaly group which is higher than the normal foetus group where morbidity rate is only 1.59% and mortality rate is 3.60%. CONCLUSION The targeted USG and followup, decision making by specialists is important in reducing foetal and also maternal morbidity and mortality. Prevalence of congenital anomaly was 1.63% and anomalies of the cardiovascular system were the most common observed in our study. Majority cases were not associated with any risk factor. However, GDM is the most commonly associated one. Others are polyhydramnios and IUGR. Routine targeted USG by radiologist at 18-22 weeks is an important measure for early detection of malformation. This helps in primary prevention of disability and reduces perinatal morbidity and mortality. This prenatal diagnosis helps in reducing surgery rate and reduces maternal morbidity and mortality.
Authors and Affiliations
Udaya Aruna Sundaram, Uma Dharmalingam, Sudharshini Thayuman Santhakumar
Keywords
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- EP ID EP226165
- DOI 10.14260/Jemds/2017/919
- Views 103
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