Prenatal Diagnosis of Congenital Malformations in Douala General Hospital
Author(s)
Tchente Nguefack Charlotte1,2*,
Nzesseu Djomo Aurore2,3,
Brulet Charlotte4,
Barla Esther5,
Belley Priso Eugene2,6
Affiliation(s)
1 Faculty of Medicine and Pharmaceutics Science, University of Douala, Douala, Cameroon. 2 Obstetrics and Gynecology Unit, Douala General Hospital, Douala, Cameroon. 3 Faculty of Health Science, University of Mountains, Bagangté, Cameroon. 4 Cabinet Médical Dr Brulet, Douala, Cameroon. 5 Pediatrics Unit, Douala General Hospital, Douala, Cameroon. 6 Faculty of Medicine and Biomedical Science, University of Yaoundé, Yaoundé, Cameroon.
1 Faculty of Medicine and Pharmaceutics Science, University of Douala, Douala, Cameroon. 2 Obstetrics and Gynecology Unit, Douala General Hospital, Douala, Cameroon. 3 Faculty of Health Science, University of Mountains, Bagangté, Cameroon. 4 Cabinet Médical Dr Brulet, Douala, Cameroon. 5 Pediatrics Unit, Douala General Hospital, Douala, Cameroon. 6 Faculty of Medicine and Biomedical Science, University of Yaoundé, Yaoundé, Cameroon.
ABSTRACT
To determine the prevalence of congenital malformations and the proportion of cases diagnosed before birth; to specify this proportion according to the type of malformation and the sonographer qualification. Methods: It was a cross-sectional study carried out at the Douala General Hospital in the obstetric and neonatal units over a period of 42 months, from January 2008 to June 2012. The procedure consisted of; firstly an explanation of the study purpose with consent of parents obtained, thereafter, the parents were interviewed and data extracted from their files. The new born had a complete clinical exam. Morphological and biological assessment were done to ascertain diagnosis if needed. They were then followed up for 48 hours. Data were analysed using SPSS. Statistical analyses were mainly descriptive: mean, median, mode and frequency were calculated. Results: During this period, 6048 neonates were examined, 99 of whom had a malformation giving a prevalence of 1.64%. Musculoskeletal defects were the most common (36.4%), followed by digestive tract defects (22.2%). Ultrasounds were carried out mainly in the second term. Among the malformed babies, only 16.2% were diagnosed during the prenatal period. The obstetricians did better than radiologist in the prenatal diagnosis of congenital malformations. All the urinary tract malformations and 33.3% of the polymalformations were diagnosed by prenatal echography. Among the malformed babies, 33% died within the first 48 hours of life and poly-malformed babies were more concerned (66.7%). Conclusion: The prevalence of congenital birth defect was 1.64%. The rate of prenatal diagnosis remained low, meanwhile one third of the affected babies die after births. An early diagnosis would anticipate on medical care at birth and allow therapeutics abortions when indicated.
To determine the prevalence of congenital malformations and the proportion of cases diagnosed before birth; to specify this proportion according to the type of malformation and the sonographer qualification. Methods: It was a cross-sectional study carried out at the Douala General Hospital in the obstetric and neonatal units over a period of 42 months, from January 2008 to June 2012. The procedure consisted of; firstly an explanation of the study purpose with consent of parents obtained, thereafter, the parents were interviewed and data extracted from their files. The new born had a complete clinical exam. Morphological and biological assessment were done to ascertain diagnosis if needed. They were then followed up for 48 hours. Data were analysed using SPSS. Statistical analyses were mainly descriptive: mean, median, mode and frequency were calculated. Results: During this period, 6048 neonates were examined, 99 of whom had a malformation giving a prevalence of 1.64%. Musculoskeletal defects were the most common (36.4%), followed by digestive tract defects (22.2%). Ultrasounds were carried out mainly in the second term. Among the malformed babies, only 16.2% were diagnosed during the prenatal period. The obstetricians did better than radiologist in the prenatal diagnosis of congenital malformations. All the urinary tract malformations and 33.3% of the polymalformations were diagnosed by prenatal echography. Among the malformed babies, 33% died within the first 48 hours of life and poly-malformed babies were more concerned (66.7%). Conclusion: The prevalence of congenital birth defect was 1.64%. The rate of prenatal diagnosis remained low, meanwhile one third of the affected babies die after births. An early diagnosis would anticipate on medical care at birth and allow therapeutics abortions when indicated.
Cite this paper
Charlotte, T. , Aurore, N. , Charlotte, B. , Esther, B. , Eugene, B. , (2015) Prenatal Diagnosis of Congenital Malformations in Douala General Hospital. Open Journal of Obstetrics and Gynecology, 5, 839-848. doi: 10.4236/ojog.2015.515119.
Charlotte, T. , Aurore, N. , Charlotte, B. , Esther, B. , Eugene, B. , (2015) Prenatal Diagnosis of Congenital Malformations in Douala General Hospital. Open Journal of Obstetrics and Gynecology, 5, 839-848. doi: 10.4236/ojog.2015.515119.
References
[1] Geneva, WHO. The Sixty-Third World Assembly of the Health.
http://apps.who.int/gb/ebwha/pdf_files/WHA63-REC1/WHA63_REC1-en.pdf [2] Harper, P.S. (1998) Practical Genetic Counselling. 5th Edition, Butterworth Heinemann, Boston. [3] Perthus, I., Amar, E., De Vigan, C., Doray, B. and Francannet, C. (2008) Registries of Congenital Malformations in France: Situation in 2008. BEH, 28-29, 246-248. [4] Coulibaly-Zerbo, F, Amorissani-Folquet, F., Kacou-Kakou, A., Sylla, M., Noua, F, Kramo, E., Yapo, G., Do Rego, A., Prince, A., Toure, M., Houenou, Y. and Kouame Konan, J. (1997) Epidemiological Study of the Congenital Malformation. Médecine d’Afrique Noire, 44, 411-414. [5] Tayebi, N., Yazdani, K. and Naghshin, N. (2010) The Prevalence of Congenital Malformations and Its Correlation with Consanguineous Marriages. Oman Medical Journal, 25, 37-40.
http://dx.doi.org/10.5001/omj.2010.9 [6] Riley, M.M., Halliday, J.L. and Lumley, J.M. (1998) Congenital Malformations in Victoria, Australia, 1983-95: An Overview of Infant Characteristics. Journal of Paediatrics and Child Health, 34, 233-240.
http://dx.doi.org/10.1046/j.1440-1754.1998.00208.x [7] Waqas, J., Farooq, A., Taimoor, J. and Muhammad, S.M. (2009) Prevalence of Gross Congenital Malformations at Birth in the Neonates in a Tertiary Care Hospital. A.P.M.C., 3, 47-50. [8] Amon-Tanoh-Dick, F., Gouli, J.C., N’Gouan-Domoua, A.M., Aka, J. and Napon-Kini, H. (2006) Epidemiology and Immediate Neonatal Outcome of New Borns with Congenital Malformations in CHU de Yopougon Abidjan-Cote d’Ivoire. Revue internationale des Sciences Médicales, 8, 7-12. [9] Grover, N. (2000) Congenital Malformations in Shimla. The Indian Journal of Pediatrics, 67, 249-251.
http://dx.doi.org/10.1007/BF02758158 [10] Bhat, B.V. and Babu, L. (1998) Congenital Malformations at Birth—A Prospective Study from South India. The Indian Journal of Pediatrics, 65, 873-881.
http://dx.doi.org/10.1007/BF02831352 [11] Dolk, H., Loane, M. and Garne, E. (2010) The Prevalence of Congenital Anomalies in Europe. Advances in Experimental Medicine and Biology, 686, 349-364.
http://dx.doi.org/10.1007/978-90-481-9485-8_20 [12] Verma, M., Chhatwal, J. and Singh, D. (1991) Congenital Malformations—A Retrospective Study of 10,000 Cases. The Indian Journal of Pediatrics, 58, 245-252.
http://dx.doi.org/10.1007/BF02751129 [13] Monteleone-Neto, R. and Castilla, E.E. (1994) Apparently Normal Frequency of Congenital Anomalies in the Highly Polluted Town of Cubatao, Brazil. American Journal of Medical Genetics, 52, 319-323.
http://dx.doi.org/10.1002/ajmg.1320520313 [14] Levi, S. (2004) Prenatal Screening of Congenital Birth Defects. Revue Hospitals. BE., 2. [15] Garne, E., Loane, M., Dolk, H., De Vigan, C., Scarano, G., Tucker, D., Stoll, C., Gener, B., Pierini, A., Nelen, V., Rosch, C., Gillerot, Y., Feijoo, M., Tincheva, R., Queisser-Luft, A., Addor, M.C., Mosquera, C., Gatt, M. and Barisic, I. (2005) Prenatal Diagnosis of Severe Structural Congenital Malformations in Europe. Ultrasound in Obstetrics & Gynecology, 25, 6-11.
http://dx.doi.org/10.1002/uog.1784 [16] Jouannic, J.-M. (2005) The Sonographer, the Fetus and the Epidemiologist. JGYN., 34, 7. [17] De Vigan, C., Khoshnood, B., Lhomme, A., Vodovar, V., Goujard, J. and Goffinet, F. (2005) Prevalence and Prenatal Diagnosis of Congenital Malformations in the Parisian Population: Twenty Years of Surveillance by the Paris Registry of Congenital Malformations. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 34, 8-16.
http://dx.doi.org/10.1016/S0368-2315(05)82665-1 [18] Levi, S. (2003) Mass Screening for Fetal Malformations: The Eurofetus Study. Ultrasound in Obstetrics & Gynecology, 22, 555-558.
http://dx.doi.org/10.1002/uog.935 [19] Claude Sureau, C. and Henrion, R. (2005) Le rapport du comité technique de l’échographie de dépistage prénatal.
http://www.cfef.org/archives/lettres/DocusCTE/rapportCTE.pdf
[1] Geneva, WHO. The Sixty-Third World Assembly of the Health.
http://apps.who.int/gb/ebwha/pdf_files/WHA63-REC1/WHA63_REC1-en.pdf [2] Harper, P.S. (1998) Practical Genetic Counselling. 5th Edition, Butterworth Heinemann, Boston. [3] Perthus, I., Amar, E., De Vigan, C., Doray, B. and Francannet, C. (2008) Registries of Congenital Malformations in France: Situation in 2008. BEH, 28-29, 246-248. [4] Coulibaly-Zerbo, F, Amorissani-Folquet, F., Kacou-Kakou, A., Sylla, M., Noua, F, Kramo, E., Yapo, G., Do Rego, A., Prince, A., Toure, M., Houenou, Y. and Kouame Konan, J. (1997) Epidemiological Study of the Congenital Malformation. Médecine d’Afrique Noire, 44, 411-414. [5] Tayebi, N., Yazdani, K. and Naghshin, N. (2010) The Prevalence of Congenital Malformations and Its Correlation with Consanguineous Marriages. Oman Medical Journal, 25, 37-40.
http://dx.doi.org/10.5001/omj.2010.9 [6] Riley, M.M., Halliday, J.L. and Lumley, J.M. (1998) Congenital Malformations in Victoria, Australia, 1983-95: An Overview of Infant Characteristics. Journal of Paediatrics and Child Health, 34, 233-240.
http://dx.doi.org/10.1046/j.1440-1754.1998.00208.x [7] Waqas, J., Farooq, A., Taimoor, J. and Muhammad, S.M. (2009) Prevalence of Gross Congenital Malformations at Birth in the Neonates in a Tertiary Care Hospital. A.P.M.C., 3, 47-50. [8] Amon-Tanoh-Dick, F., Gouli, J.C., N’Gouan-Domoua, A.M., Aka, J. and Napon-Kini, H. (2006) Epidemiology and Immediate Neonatal Outcome of New Borns with Congenital Malformations in CHU de Yopougon Abidjan-Cote d’Ivoire. Revue internationale des Sciences Médicales, 8, 7-12. [9] Grover, N. (2000) Congenital Malformations in Shimla. The Indian Journal of Pediatrics, 67, 249-251.
http://dx.doi.org/10.1007/BF02758158 [10] Bhat, B.V. and Babu, L. (1998) Congenital Malformations at Birth—A Prospective Study from South India. The Indian Journal of Pediatrics, 65, 873-881.
http://dx.doi.org/10.1007/BF02831352 [11] Dolk, H., Loane, M. and Garne, E. (2010) The Prevalence of Congenital Anomalies in Europe. Advances in Experimental Medicine and Biology, 686, 349-364.
http://dx.doi.org/10.1007/978-90-481-9485-8_20 [12] Verma, M., Chhatwal, J. and Singh, D. (1991) Congenital Malformations—A Retrospective Study of 10,000 Cases. The Indian Journal of Pediatrics, 58, 245-252.
http://dx.doi.org/10.1007/BF02751129 [13] Monteleone-Neto, R. and Castilla, E.E. (1994) Apparently Normal Frequency of Congenital Anomalies in the Highly Polluted Town of Cubatao, Brazil. American Journal of Medical Genetics, 52, 319-323.
http://dx.doi.org/10.1002/ajmg.1320520313 [14] Levi, S. (2004) Prenatal Screening of Congenital Birth Defects. Revue Hospitals. BE., 2. [15] Garne, E., Loane, M., Dolk, H., De Vigan, C., Scarano, G., Tucker, D., Stoll, C., Gener, B., Pierini, A., Nelen, V., Rosch, C., Gillerot, Y., Feijoo, M., Tincheva, R., Queisser-Luft, A., Addor, M.C., Mosquera, C., Gatt, M. and Barisic, I. (2005) Prenatal Diagnosis of Severe Structural Congenital Malformations in Europe. Ultrasound in Obstetrics & Gynecology, 25, 6-11.
http://dx.doi.org/10.1002/uog.1784 [16] Jouannic, J.-M. (2005) The Sonographer, the Fetus and the Epidemiologist. JGYN., 34, 7. [17] De Vigan, C., Khoshnood, B., Lhomme, A., Vodovar, V., Goujard, J. and Goffinet, F. (2005) Prevalence and Prenatal Diagnosis of Congenital Malformations in the Parisian Population: Twenty Years of Surveillance by the Paris Registry of Congenital Malformations. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 34, 8-16.
http://dx.doi.org/10.1016/S0368-2315(05)82665-1 [18] Levi, S. (2003) Mass Screening for Fetal Malformations: The Eurofetus Study. Ultrasound in Obstetrics & Gynecology, 22, 555-558.
http://dx.doi.org/10.1002/uog.935 [19] Claude Sureau, C. and Henrion, R. (2005) Le rapport du comité technique de l’échographie de dépistage prénatal.
http://www.cfef.org/archives/lettres/DocusCTE/rapportCTE.pdf