INCIDENCE AND PATTERNS OF MAJOR CONGENITAL ANOMALIES AT SAINT PAUL’S HOSPITAL MILLINIUM MEDICAL COLLEGE

Abstract

ABSTRACT Background:-Early developmental stages are susceptible to disruption because it is the period for organogenesis which refers to the 4th to 8th weeks of development. Congenital malformation is defined as “a permanent change produced by an intrinsic abnormality of development in a body structure during prenatal life”. Prevalence of major congenital malformations in different population around the world has shown considerable variation and ranges from less than 1% up to 8%. For various reasons, there is scarce of data and research on birth defects in Ethiopia. Objective: - To assess the incidence of major congenital anomalies and their pattern of distribution at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, from Sept 1, 2018 to December 31,2018. Methods:-A hospital based cross sectional study was conducted at SPHMMC for 4 months, from September 1, 2018 to December 31,2018. All Women admitted for elective termination of pregnancy for fetal congenital anomaly; those admitted for 2nd TM abortion care services and expel a congenitally malformed fetus at or beyond 20 weeks of gestational age; and those admitted to labor and delivery ward and give birth to congenitally malformed baby were involved in the study. The data was collected by BSC midwifes, nurses, interns and residents working at abortion care and service unit, labor and delivery ward and NICU. Data was collected using interview-administered questionnaire. Data was cleaned and entered into Epi Info version 7 and then exported to SPSS version 20 for analysis. In the analysis process, the frequency distribution of variables was calculated Results:- Among a total of 4050 outcomes during the study period, there were 3675 deliveries and 375 cases of 2nd trimester abortion including elective termination of pregnancy for fetal anomalies (ETOPFA ), safe and spontaneous abortions. Out of these total outcome there were 115 major anomaly affected cases making the total incidence of congenital anomaly of 312.93 per 10,000 births or overall proportion of birth defects 2.8%. The mean age of mothers was 28+5. Of all 115 major anomaly affected cases: nervous system accounted 33.3%, congenital heart disease 19.6%, digestive system 19%, genitourinary system 12.4%, musculoskeletal system 5.9%, genetic/chromosomal4.6%, respiratory system 3.9% and the rest 1.3% were unclassified. Conclusions and Recommendations: The overall magnitude of birth defect was 2.8%. Seven patterns of major congenital anomalies were identified; nervous system was the most frequent by accounting one third, followed by congenital heart disease and digestive system each accounting 10 almost one fifth of major congenital anomalies. The medical workforce and managers should give emphasis to congenital anomalies. Keywords: Congenial anomalies, Hospital, Patterns, Addis Ababa