Manzoor Uzma, Saad Muhammad, Ali Sadaqat, Bano Sadia, Shahzad Uzma, Zain Muhammad
Obstetrics and Gynecology, Independent Medical College, Faisalabad, PAK.
Internal Medicine, Ameer-ud-Din Medical College, Lahore, PAK.
Cureus. 2024 Dec 28;16(12):e76506. doi: 10.7759/cureus.76506. eCollection 2024 Dec.
Introduction Congenital malformations are a major cause of perinatal morbidity and mortality in developing countries and are assuming greater importance than ever before. They affect a variety of organ systems and various etiologies have been identified in literature including Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus, Herpes Simplex (TORCH) infections, exposure to pollutants, consumption of tobacco and alcohol, and advanced maternal age. In developing countries, diagnosis is frequently delayed which leads to poorer outcomes. Method All patients with a singleton pregnancy, with either a diagnosis of congenital anomaly from 28 to 37 weeks of gestation on ultrasonography (USG) or the discovery of an anomalous fetus after delivery were selected. Results Out of 572 patients delivered in one year, 29 (5.1%) delivered babies with congenital anomalies. Seventeen (59%) patients with a congenitally anomalous fetus were primigravida and 18 (62.1%) belonged to the age group >35 years. Twenty-three (79.3%) patients were diagnosed with congenital anomalies on USG at a gestational age of 28-37 weeks. The most common associations with congenital anomalies were advanced maternal age (37.9%), gestational diabetes mellitus (GDM) (20.6%), and lack of folic acid intake (10.3%). The most common types of congenital anomalies were central nervous system (CNS) anomalies (41.4%), musculoskeletal anomalies (20.6%), and gastrointestinal tract (GIT) anomalies (17.2%). Conclusion Neural tube defects are the most common and can be prevented by ensuring folate supplementation, especially during the first trimester. As part of family planning, new couples should be counseled regarding the risks of advanced maternal age. For diabetic mothers, emphasis should be placed on glycemic control and dietary restrictions.
引言
先天性畸形是发展中国家围产期发病和死亡的主要原因,且其重要性正日益凸显。它们会影响多种器官系统,文献中已确定了各种病因,包括弓形虫病、其他(梅毒、水痘 - 带状疱疹、细小病毒B19)、风疹、巨细胞病毒、单纯疱疹(TORCH)感染、接触污染物、吸烟和饮酒,以及产妇年龄偏大。在发展中国家,诊断往往延迟,这导致预后较差。
方法
选取所有单胎妊娠患者,这些患者在妊娠28至37周经超声检查(USG)诊断为先天性异常,或在分娩后发现异常胎儿。
结果
在一年分娩的572例患者中,29例(5.1%)分娩出患有先天性畸形的婴儿。17例(59%)胎儿患有先天性畸形的患者为初产妇,18例(62.1%)年龄大于35岁。23例(79.3%)患者在孕28 - 37周时经超声检查诊断为先天性异常。与先天性畸形最常见的关联因素是产妇年龄偏大(37.9%)、妊娠期糖尿病(GDM)(20.6%)和叶酸摄入不足(10.3%)。先天性畸形最常见的类型是中枢神经系统(CNS)异常(41.4%)、肌肉骨骼异常(20.6%)和胃肠道(GIT)异常(17.2%)。
结论
神经管缺陷是最常见的,可通过确保补充叶酸来预防,尤其是在孕早期。作为计划生育的一部分,应向新婚夫妇提供关于产妇年龄偏大风险的咨询。对于糖尿病母亲,应强调血糖控制和饮食限制。