Efficacy of Prenatal Ultrasonographic Diagnosis of Congenital Anomalies

ABSTRACT

During a 6-year period, from January 1990 to December 1995, 101 neonates with congenital anomalies were admitted to the division of pediatric surgery of Youngdong Severance Hospital. Fifty eight of them had prenatally detectable anomalies by ultrasonography and all of them had prenatal screening more than once with ultrasound. The abnormalities were prenatally detected in 24 neonates (41%). The detection rate was 70% in patients who had the prenatal screening at our hospital, whereas, the rate was 24% when it was performed at other medical facilities. Duodenal and jejunoileal atresias showed the highest detection rate (86%) and the next was the abdominal mass. The esophageal atresia was suggested by maternal polyhydramnios in 3 patients (25%). The only one patient with diaphragmatic hernia (17%) and no patients with gastroschisis were prenatally detected. The mean interval from birth to operation was 32 hours in the prenatally detected patients and 50 hours in the nondetected. The complication rate and the mortality after emergency operation were 20% and 7% in the detected group and 58% and 23% in the nondetected, respectively. The average period of the hospitalization was 20 days in the detected group and 39 days in the nondetected. We conclude that the prenatal detection of anomalies was necessary in order to give adequate care to the mothers and the babies, including early transfer to the tertiary care hospital, the decision of the optimal timing of delivery and of the timing of operation for babies. The prenatal diagnosis was also helpful to reduce the operative complication and the mortality.