Frequency and pattern of distribution of antenatally diagnosed congenital anomalies and the associated risk factors

To find the frequency and pattern of distribution of antenatally diagnosed congenital anomalies and the associated risk factors. This descriptive study was carried out at the department of Obstetrics and Gynecology, Lady Reading Hospital Peshawar from March 2012to April 2013. Women with ultrasound report of congenitally abnormal fetus irrespective of the gestational age were included. They were evaluated for the presence of risk factors including periconceptional use of folic acid, maternal medical disorders e.g diabetes, epilepsy and history of smoking, maternal and paternal ages, consanguineous marriages and family history of anomalies. A total of 62 women were included in the study. Fifty seven [91.9%] were having isolated anomalies while 5 [8.1%] presented with complex anomalies. Central nervous system [CNS] was the most commonly involved system [79%]. Lack of folic acid use and consanguineous marriages were two most important risk factors; however their correlation with congenital anomalies was not significant. Forty eight [77.4%] women have never used folic acid and consanguineous relation was present in 52 [83.9%]. Other risk factors like maternal medical disorder e.g. diabetes, epilepsy, maternal and paternal ages, family history and maternal smoking were non-significant. Lack of periconceptional use of folic acid and consanguineous marriages were two most important risk factors. Awareness among the general population and improvement in the antenatal care can help in the early detection and management of congenital anomalies

Twin delivery: perinatal outcome of the second born twin

The objective of this study was to compare the perinatal outcome of first and second twin in terms of perinatal morbidity and mortality in vaginal delivery. This comparative study was conducted at Department of Obstetrics and Gynaecology, Lady Reading Hospital Peshawar from April 2006 to February 2007. Fifty patients with twin gestations admitted to labour ward for delivery at and above 36weeks´ gestation were selected according to the inclusion/exclusion criteria. Information including maternal age, parity, birth weight, Apgar score, perinatal morbidity and mortality of both twins were recorded on a semi structured proforma and analysed by chi square test using SPSS v 12. The differences of the Apgar scores at one minute and five minute were significantly increased in the second twin compared to that of the first twin [p =0.040, and 0.038 respectively]. The admission to nursery was also found to be significantly increased in second twins as compared to first twins [p = 0.43]. The perinatal morbidity was also found to be significantly increased in second twins than the first twins [p= 0.05], while neonatal mortality was not statistical significant. The perinatal outcome of vaginally delivered twins at or after 36weeks' of gestation showed that second twins are at greater risks of perinatal morbidity than the first born twins. But the early neonatal mortality was not significantly different between the two groups