Akinmoladun J A, Ogbole G I, Lawal T A, Adesina O A
Department of Radiology, University College Hospital, Ibadan, Nigeria.
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Niger Med J. 2015 Jul-Aug;56(4):263-7. doi: 10.4103/0300-1652.169705.
Congenital anomalies are among the leading causes of fetal and infant morbidity and mortality worldwide. Prenatal ultrasound (US) screening has become an essential part of antenatal care in the developed world. Such practice is just evolving in the developing countries such as Nigeria. The aim of this article is to present our initial experience and demonstrate the effectiveness of a prenatal US screening program in detecting congenital malformation in a developing country.
This was a prospective evaluation of the prenatal US screenings conducted at a major referral hospital in Southwestern Nigeria. All pregnant women referred to the antenatal clinic for mid-trimester screening during the period of study were assessed.
Two hundred and eighty-seven pregnant women (5 with twin gestations) were presented for fetal anomaly scan during the study period. Twenty-nine anomalies (9.9%) were detected among the scanned population. Sixteen of the anomalies were followed to delivery/termination with a specificity of 93.5%. The commonest malformations were demonstrated in the genitourinary tract (34.5%) followed by malformations within the central nervous system (27.6%). Six (20.6%) of the anomalies were lethal. Five of the anomalies were surgically correctable.
Institutions and hospitals across Nigeria and other low- and middle-income countries need to develop policies and programs that would incorporate a standardized routine screening prenatal US in order to improve feto-maternal well-being and reduce the high perinatal mortality and morbidity in developing nations.
先天性异常是全球范围内胎儿和婴儿发病及死亡的主要原因之一。产前超声(US)筛查已成为发达国家产前护理的重要组成部分。而在尼日利亚等发展中国家,这种做法才刚刚兴起。本文旨在介绍我们的初步经验,并证明产前超声筛查计划在发展中国家检测先天性畸形方面的有效性。
这是对尼日利亚西南部一家主要转诊医院进行的产前超声筛查的前瞻性评估。对研究期间转诊至产前诊所进行孕中期筛查的所有孕妇进行了评估。
在研究期间,有287名孕妇(其中5例为双胎妊娠)接受了胎儿畸形扫描。在扫描人群中检测到29例异常(9.9%)。其中16例异常随访至分娩/终止妊娠,特异性为93.5%。最常见的畸形出现在泌尿生殖道(34.5%),其次是中枢神经系统内的畸形(27.6%)。6例(20.6%)异常是致命的。5例异常可通过手术矫正。
尼日利亚及其他低收入和中等收入国家的机构和医院需要制定政策和计划,将标准化的常规产前超声筛查纳入其中,以改善母婴健康,降低发展中国家高围产期死亡率和发病率。