Abstract

There is paucity of knowledge on the causes, diagnosis, management and prevention of fetal congenital anomalies in Africa. The chapter will highlight on the general causes and specific factors concerning congenital anomalies in Africa. The problems of diagnosis and management of congenital anomalies will be extensively discussed. There is also going to be a discussion on how fetal anomalies contribute to maternal and perinatal mortality and morbidity. Screening of congenital anomalies is another black point and will be discussed emphasizing on simple strategies applicable in resource constrained environment. A section will be dedicated on prevention of fetal congenital anomalies, particularly prevention of specific factors that increase the risk of fetal anomalies in Africa. Finally, there will also be discussion on collaborative care as a panacea in the management of fetal congenital fetal anomalies, including my experience in this area. Specific examples will be given to illustrate the utility of collaborative in resource limited countries.

Highlights

  • Congenital anomalies can be defined as structural or functional anomalies [e.g. metabolic disorders] that occur during intrauterine life and can be identified prenatally, at birth or sometimes may only be detected later in infancy, such as hearing defect [1]

  • Data is usually obtained from registries of congenital anomalies and this indicates that congenital anomalies are seen in 2–3% of newborns which is similar to what is seen in the industrialized world [7]

  • In developed countries common causes of perinatal and neonatal have been dealt with and congenital anomalies are seen as causes of perinatal and neonatal death

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Summary

Introduction

Congenital anomalies can be defined as structural or functional anomalies [e.g. metabolic disorders] that occur during intrauterine life and can be identified prenatally, at birth or sometimes may only be detected later in infancy, such as hearing defect [1]. Imagine a situation where a pregnant woman goes in to labor with a fetus with an undiagnosed congenital anomaly that preclude vaginal delivery and as we know more than half of pregnant women in developing countries labor and deliver at home. In this scenario the labor be prolonged and with time obstructed, membranes would have ruptured, chorio-amnionitis would have set in and as consequence develop postpartum hemorrhage or puerperal sepsis and die or she develop ruptured uterus and die. I will discuss congenital anomalies, their causes, prenatal diagnosis, treatment and prevention with the peculiarities of the African environment in view

Background
Causes of congenital anomalies
Chromosomal abnormalities as cause of birth defects
Drugs and birth defects
Anti-epileptics
Deficiencies of essential elements and vitamins
Surgically correctable and non-surgically correctable
Absence of laboratories for genetic and chromosomal analysis
Management of prenatally diagnosed congenital anomalies in Africa
10. Illustrative cases
11. Preventing birth defects: which approach?
Our goal is to eliminate causative factors of congenital defect
12. Specific measures
Findings
13. Conclusion
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