ABSTRACT
OBJECTIVE: To ascertain the prevalence and pattern of congenital abnormalities that are peculiar to the Niger Delta area of Nigeria. METHODS: This is a descriptive retrospective cross-sectional study. It involved data from the labor ward and neonatal birth registers of the University of Port Harcourt Teaching Hospital on the total number of births and the babies that were delivered with major birth defects between August 2011 and December 2014. We also conducted a statistical comparison of the prevalence of congenital abnormalities in the Niger Delta with that in other regions of Nigeria and the developed world of Europe. RESULTS: Out of the 7,670 deliveries that occurred, 159 maternities had babies with major birth defects giving a prevalence of 20.73 cases per 1,000 live births. This figure is far more than that which was obtained in other regions of Nigeria -4.15:cases per 1,000 live births in the South East (P<0.001), 15.84:1,000 in the South West (P<0.01), and 5.51:1,000 in the North East (P<0.001). Eighty-five (53.46%) of the defects occurred in 1,681 unbooked patients, while 74 (46.54%) happened in 5,989 booked maternities (P<0.001). The predominant abnormalities were those of the central nervous system at 27.0%, gastrointestinal system 11.95%, cardiovascular system 10.69%, anterior abdominal wall 8.18%, skeleton 6.29%, and chromosomal abnormalities at 5.66%. CONCLUSION: The prevalence of major birth defects at the University of Port Harcourt Teaching Hospital was 20.73 cases per 1,000 live births and it was more in the unbooked than the booked maternities. All body systems were affected with those of the central nervous system predominating at 27.0% of the total diagnosed defects.
ABSTRACT
INTRODUCTION: To evaluate the performance of first trimester nuchal translucency scan screening among pregnant women in Nigeria. METHODS: A prospective observational and questionnaire based study involving 510 pregnant women between 11(+0) and 13(+6) weeks. Routine counselling and nuchal translucency measurement was conducted using the FMF, London guidelines. Chorionic villous sampling was done at NT ≥ 2.5 mm or ≥ 95th centile. RESULTS: Five hundred and ten out of 542 (94.1%) were analysed, mainly referred by health care workers (87.2%) and from predominantly private facilities (94.3%). The number of NT scans performed increased in successive years with corresponding decrease in the mean scanning time. Scan was successfully completed at first attempt in (96.5%), with mean scanning time of 28.3 minutes. Nuchal translucency increases with gestational but not maternal age. The median and 95th centile at 11(+0) week was 1.2mm and 1.7 mm and at 13(+6) weeks was 1.5 mm and 2.2 mm. Using a cut-off of ≥ 2.5 mm or ≥ 95th centile, 17 (3.3%) screened positive. Three out of the 17 had invasive testing and 2 (DR = 66.7%) were confirmed trisomy 21, with a false positive rate of 5.9%. Although majority (86.4%) were willing to have invasive testing, only few (3 or 17.6%) of the high risk group had testing. CONCLUSION: The study demonstrated that NT scan is feasible as a screening tool in pregnancy in Nigeria. Measures of improving utilization include wider dissemination of information, provision of dedicated NT clinics and manpower training.
