Abstract
BackgroundVisible congenital malformations (VCMs) are one of the principal causes of disability in the world. Prenatal diagnosis is a paramount mandatory integral part of the follow up of pregnancies with VCM of the foetus in high-income setting. We aimed to determine the incidence of prenatal diagnosis of VCMs in a low-resource setting with no policy on antenatal diagnosis of VCMs.MethodsWe carried out a prospective cohort multicenter study from July 2015 to June 2016 in 10 randomly selected maternity units of Yaoundé, Cameroon. We enrolled all newborns with one or more detectable VCMs at birth. Variables studied were findings of the 1st, 2nd and 3rd trimesters’ obstetrical ultrasound scans, in order to establish a concordance between the clinical and sonographic diagnoses of the VCMs and determine the frequency of antenatal diagnosis as well as the rate of medical abortion.ResultsThe incidence of VCMs was 9 per 1000 births. The main VCMs were malformations of the skeletal (4.3%), neurological (2.2%), and gastrointestinal (2.1%) systems. The sex ratio was 1.1. Among the malformed newborns, 37% were premature and in 18.5% the diagnosis of a VCM was confirmed after a therapeutic termination of pregnancy (following suggestive findings of a malformation on antenatal ultrasound scan). The prevalence of sonographic antenatal diagnosis of VCMs was 21%. Hydrocephalus was the most diagnosed VCM antenatally. The mean gestational age at which antenatal clinics were initiated was 15 ± 5 weeks. The mean number of obstetrical ultrasound scans performed was two.ConclusionThe incidence of VCMs in our resource-limited setting is high and antenatal diagnosis rates are very low. Overall, our study emphasizes on the importance antenatal diagnosis of VCMs, often overlooked in our setting. The goal being to reduce maternal and foetal morbidity in a setting already burdened by a high maternal and neonatal mortality.
Highlights
Visible congenital malformations (VCMs) are one of the principal causes of disability in the world
Incidence of visible congenital malformations We identified 189 cases of VCMs out of a total of 21,113 births, an overall incidence of 9 cases per 1000 births
Public health authorities’ integration of an algorithm for antenatal screening of VCMs in our context could significantly reduce the under-reporting of VCMs in our setting and go a long way to terminate VCMs incompatible with life during pregnancy or help anticipate the neonatal care of neonates with VCMs requiring specific treatment and attention at birth
Summary
Visible congenital malformations (VCMs) are one of the principal causes of disability in the world. Prenatal diagnosis is a paramount mandatory integral part of the follow up of pregnancies with VCM of the foetus in high-income setting. Due to limited antenatal diagnostic tests in subSaharan Africa (SSA), visible congenital malformations (VCMs) are easier to diagnose than occult congenital malformations (CMs) [2]. Children growing with such handicaps often face psychological trauma due to peer or societal stigmatization [1]. To this end, the importance of antenatal diagnosis of VCMs in SSA, cannot be overemphasized. Though not yet a routine practice in these resource-limited settings, we cannot argue the merits of antenatal diagnosis of CMs, especially VCMs which are easier to diagnose. We proposed to conduct this study to determine the frequency of antenatal diagnosis of VCMs in a SSA setting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
