PREVALENCE AND MANAGEMENT OF ANENCEPHALY AT SAIDU TEACHING HOSPITAL, SWAT
Abstract
Background: Anencephaly is a fatal congenital abnormality characterised by absence of cerebralhemisphere and cranial vault. Overall incidence of anencephaly is 3.8–6.0/1,000 births. This studywas conducted to determine the prevalence, diagnosis and management of anencephaly in DistrictSwat. Methods: This Prospective study was carried out over a period of one year from January2007 to December 2007 at Saidu Teaching Hospital/Saidu Medical College Swat. Pregnantwomen having foetuses with neural tube defects (NTDs) admitted in Labour Room/ObstetricWard of the Saidu Teaching Hospital Swat were selected as subjects. Those women who deliverednormal babies were taken as control subjects. A proper history was taken from each subject and allthe relevant information were recorded on a proforma. Results: A total of 5,560 subjects wereincluded in this study. Out of them, 69 were having NTDs, 63 had anencephaly, 4 had spinabifida, and 2 foetuses were having multiple neural tube defects. Prevalence of anencephaly was11.33/1000 births and that of spina bifida was 0.72/1000 births. Eighty percent (80%) anencephalyand 50% spina bifida were diagnosed by ultrasonography. Most of the cases (52, 75.36%) weredelivered through normal vaginal delivery after induction. Twelve (17.40%) had spontaneousvaginal delivery, 4 (5.80%) had caesarean section, and hysterectomy was done in 1 (1.45%).Conclusion: Anencephaly is common congenital anomaly in Swat. Complications can beprevented by implementing screening program for early diagnosis, treatment, and management.Prevalence can be decreased by folic acid supplementation periconceptionally.Keywords: Anencephaly, Neural tube defects, prevalence, spina bifidaReferences
Edmonds KD, Overton TG. Antenatal Care. In: Dewhurst Text
book of Obstetrics and Gynaecology for post graduate 7th Ed.
Oxford: Black -Well Science; 2006.p.572–5.
Sadler TW (Editor). Central nerves system. In: Langman’s
Medical Embryology 10th ed. New Delhi Wolters Kluwer
Health (India) Pvt. Ltd; 2006. p.293–309.
James DK, Steer PJ, Weiner CP, Gonik B, Klaish RB,
Chervanak FA. Fetal Craniao Spinal and facial abnormalities.
In: High risk pregnancy management option. 3rd ed.
Yorkshire: WB Saunders; 2007. p.369–75.
Mills JL, Von KI, Conley MR, Zeller JA, Defour DR,
Williamson RE, et al. Low vitamin B12 concentrations in
patients without anaemia: the effect of folic acid fortification
of grain. Am J Clin Nutr 2003;77:1474–7.
Waller DK, Tita AT and Annegers JF. Rates of twinning
before and after fortification of foods in the US with folic
acid. Paediatr Perinat Epidemiol 2003;17:378–83.
Khattak ST, Naheed T, Akhter S, Jamal T. Incidence and
management of neural tube defect in Peshawar. Gomal J Med
Sci 2008;6(1):41–4.
Ghani AA, Ansary EK. Neural tube defects. Ann Sudi J
Obstet Gynaecol 2006;3:38–48.
Tanne JH. Folic acid fortification decrease neural tube
defects BMJ 2005;331:592–4.
Dean SC. More folic acid advised for pregnant women. Life
Extension Magazine June 2004;171–5.
Rankin J, Glinian S, Brown R, Renwick H. The changing
prevalence of neural tube defects. Pediatr Perinat Epidamiol
;14:104–10.
Scholl TO, Johnson WE. Folic Acid: Influence on the
outcome of pregnancy. Am J Clin Nutr 2000;71(5
Suppl):1295S–1303S.
Robertson EF, Haan EA, Ranieri E, Keane RJ. The
sensitivity of ultrasound and alpha fetoprotein in population
based antenatal screening for neural tube defect, South
Australia 1996–1991. Br J Obstet Gynecol 1995;102:370–6.
Wald NJ, Law M, Jordan R. Folic Acid food fortification to
prevent neural tube defects. Lancet 1998;351:834.
Vaishnav A, Freeman NV, Patton MA. Neural tube defects
and congenital hydrocephalus in the sultanate of Oman. J
Trop Pediatric 1998;44:300–3.
Rasmussen LB, Andersen NL, Andersson G, Lange AP,
Rasmussen K, Skak-Iversen L, Skovby F, et al. Folates and
nural tube defects, Recommendations from a Danish working
group. Dan Med Bull 1998;45:213–17.
Michie CA, Chambers J, Abramsky L, Kooner JS. Folate
deficiency, neural tube defects and cardiac disease in U.K
Indian and Pakistanis. Lancet 1998;351:1105–7.
Chan A. Robertson EF, Haan EA, Ranieri E, Keane RJ. The
sensitivity of ultrasound and alpha fetoprotein and population
based antenatal screening for neural tube defect, South
Australia 1991–1996. Br J Obstet Gynaecol 1995;102:370–6.
Rothenberg SP, Costa MP, Sequeira JM, Cracco J, Roberts
JL, Weedon J, et al. Auto antibodies against folate receptors in
women with a pregnancy complicated neural tube defect. N Engl
J Med 2004;350:134–42.
Padmanabham L. Ahmed I. Sodium volproate augments
spontaneous neural tube defects. Reported Toxicol
;10:345–63.
Li Z, Ginder J, Wang H, Berry RJ, Li S, Zheng JC, et al.
Folic acid supplements during early pregnancy and likelihood
of multiple births: a population-based cohort study. Lancet
;361:380–4.
Tahir S, Aleem M, Salam F. Prevalence and management of
anencephaly at Divisional Headquarter Hospital Faisalabad.
Pak J Med Sci 2002;18:302–5.
Dolk H, Dewals P, Ygiverot M, Flechat M, Ayme S, Carnel
A, et al . Heterogenicity of NTDs in Europe. The significance
of sight of effect and presence of other major anomalies in
relation to geographic differences in prevalence. Teratology
;44:547–59.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
