ULTRASOUND DETECTION OF MATERNAL RISK FACTOR AND CONGENITAL ANOMALY IN TERTIARY CARE HOSPITALS LAHORE

Abstract

Background: Congenital anomalies constitute a serious contributor to fetal and neonatal morbidity and mortality, especially in low- and middle- income settings. Among the possible contributors are maternal risk factors, for example maternal age, pre- Pregnancy BMI, maternal diabetes, maternal intake of folic acid, other clinical comorbidities. Prenatal ultrasound scan represents a useful noninvasive tool in screening and early diagnosis of congenital structural anomalies, however the local evidence for maternal risk factors as predictors for antenatal detection and performance of ultrasound scan are few.

Objective:  To evaluate the association of maternal risk factors on the occurrence of congenital anomalies and to assess the accuracy of ultrasonography in detecting these anomalies in a tertiary care hospital in Lahore.

Methods: Descriptive Cross-Sectional Study conducted on 196 singleton pregnancies, women aged from 18-45 years, at Fuji Foundation & Ghurki Hospitals Lahore. Data collected using questionnaires & clinical records. Pearson's chi square tests were used to estimate Associations while Ultrasound Diagnostic performance using Sensitivity, Specificity, Predictive values & accuracy.

Results: This research involved 196 expectant mothers, out of which 32 (16.3%) of the unborn children had congenital anomalies, of which central nervous system deformities were most frequent (34.4%). Other deformities found included heart (15.6%), renal (12.5%), abdominal (12.5%), and musculoskeletal (6.3%) anomalies. Important risk factors concerning the deformities included maternal age, high body mass index (BMI), marriage within the same family, previous deformities in the patient’s family, lack of folic acid intake, specific gestational age interval, and abnormal amniotic fluid (p-value < 0.001). Maternal diseases related to the defects included diabetes, infections, kidney diseases, and obesity. The results of the scans appeared to be very accurate: 97% in regards to finding the defect, 100% in regards to confirming there is no defect and in general the scans had 99.5% accuracy.

Conclusion: The relationship between the health concerns of mothers and the incidence of congenital defects in newborns was studied where congenital defects in the brain or spine were noted to occur in 16.3% of babies.The researchers recommend the use of prenatal ultrasound and self-care by the mothers for reducing the occurrence of congenital defects in Pakistan.