Prevalence and Types of Congenital Anomalies in Singleton Pregnancies at a Tertiary Care Hospital

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.