Find best premium and Free Joomla templates at GetJoomlaTemplatesFree.com

Outcome of Antenatally Referred Congenital Surgical Anomalies – A Pediatric Surgeon’s Perspective (Abstract)

DK Gupta, Shilpa Sharma, Malvika Gupta
New Delhi, India

 

Abstract 

Background: With improvements in investigative modalities and increasing incidence of antenatal diagnosis of surgical anomalies, the pediatric surgeon has the added responsibility of deciding the fate of the unborn life and counselling about the ultimate outcome of the surgical anomaly diagnosed relying on his experience.

Material and methods: The clinical antenatal record files of 91 cases of patients referred to the department of pediatric surgery over a period of 4 years were thus studied in detail. The data was analysed in terms of the gestational age at presentation, anomaly detected, antenatal advice given and their postnatal outcome. All the cases were evaluated on the basis of antenatal ultrasonography. The gestational age at presentation was 12-20 wks; 21-28 wks; 29-34 wks and 34 wks – term in 13(14%); 22(24%); 35(38%) and 21(23%) cases respectively. 33(36%) were primigravida, 16 had a bad obstetric history. The distribution of cases according to diagnosis was Urological – 43(47%), GIT –12(13%), Cranial –17(19%), Spinal – 10(11%), Thoracic- 7(8%), Cleft Lip-1 (1%) and Tumor –3 (3%). Two fetuses had more than 2 anomalies –2(2%). Medical termination of pregnancy was advised for 7(7.7%) patients. There was a male predominance with a male: female ratio of 2:1

Results: Discrepancies between the antenatal and postnatal diagnosis were encountered in 8 (8.8%) cases. Postnatal surgery was done in 21(23%) cases. 40(43.9%) are in regular follow up and close observation. 7(7.7%) cases expired with and without surgery. Surgery is planned in future for 5 cases and delivery of 4 cases is awaited. 7(7.7%) cases have been lost to follow up.

Conclusions: Delivery of high-risk infants in regional centres improves neonatal surgical care. An improvement in antenatal care especially in high-risk pregnancies, prenatal diagnosis and management at tertiary care level centre is still required in developing countries.

Key words: antenatal diagnosis, congenital surgical anomalies, neonatal surgery

 

Full Text (HTML) | PDF