PREVALENCE AND MANAGEMENT OF ANENCEPHALY AT SAIDU TEACHING HOSPITAL, SWAT

Authors

  • Sania Tanweer Khattak
  • Muhammad Khan
  • Tabassum Naheed
  • Imran ud Din Khattak
  • Muhammad Ismail

Abstract

Background: Anencephaly is a fatal congenital abnormality characterised by absence of cerebral
hemisphere and cranial vault. Overall incidence of anencephaly is 3.8-6.0/1,000 births. This study
was conducted to determine the prevalence, diagnosis and management of anencephaly in District
Swat. Methods: This Prospective study was carried out over a period of one year from January
2007 to December 2007 at Saidu Teaching Hospital/Saidu Medical College Swat. Pregnant
women having foetuses with neural tube defects (NTDs) admitted in Labour Room/Obstetric
Ward of the Saidu Teaching Hospital Swat were selected as subjects. Those women who delivered
normal babies were taken as control subjects. A proper history was taken from each subject and all
the relevant information were recorded on a proforma. Results: A total of 5,560 subjects were
included in this study. Out of them, 69 were having NTDs, 63 had anencephaly, 4 had spina
bifida, and 2 foetuses were having multiple neural tube defects. Prevalence of anencephaly was
11.33/1000 births and that of spina bifida was 0.72/1000 births. Eighty percent (80%) anencephaly
and 50% spina bifida were diagnosed by ultrasonography. Most of the cases (52, 75.36%) were
delivered through normal vaginal delivery after induction. Twelve (17.40%) had spontaneous
vaginal delivery, 4 (5.80%) had caesarean section, and hysterectomy was done in 1 (1.45%).
Conclusion: Anencephaly is common congenital anomaly in Swat. Complications can be
prevented by implementing screening program for early diagnosis, treatment, and management.
Prevalence can be decreased by folic acid supplementation periconceptionally.
Keywords: Anencephaly, Neural tube defects, prevalence, spina bifida

References

Edmonds KD, Overton TG. Antenatal Care. In: Dewhurst Text

book of Obstetrics and Gynaecology for post graduate 7th Ed.

Oxford: Black -Well Science; 2006.p.572-5.

Sadler TW (Editor). Central nerves system. In: Langman's

Medical Embryology 10th ed. New Delhi Wolters Kluwer

Health (India) Pvt. Ltd; 2006. p.293-309.

James DK, Steer PJ, Weiner CP, Gonik B, Klaish RB,

Chervanak FA. Fetal Craniao Spinal and facial abnormalities.

In: High risk pregnancy management option. 3rd ed.

Yorkshire: WB Saunders; 2007. p.369-75.

Mills JL, Von KI, Conley MR, Zeller JA, Defour DR,

Williamson RE, et al. Low vitamin B12 concentrations in

patients without anaemia: the effect of folic acid fortification

of grain. Am J Clin Nutr 2003;77:1474-7.

Waller DK, Tita AT and Annegers JF. Rates of twinning

before and after fortification of foods in the US with folic

acid. Paediatr Perinat Epidemiol 2003;17:378-83.

Khattak ST, Naheed T, Akhter S, Jamal T. Incidence and

management of neural tube defect in Peshawar. Gomal J Med

Sci 2008;6(1):41-4.

Ghani AA, Ansary EK. Neural tube defects. Ann Sudi J

Obstet Gynaecol 2006;3:38-48.

Tanne JH. Folic acid fortification decrease neural tube

defects BMJ 2005;331:592-4.

Dean SC. More folic acid advised for pregnant women. Life

Extension Magazine June 2004;171-5.

Rankin J, Glinian S, Brown R, Renwick H. The changing

prevalence of neural tube defects. Pediatr Perinat Epidamiol

;14:104-10.

Scholl TO, Johnson WE. Folic Acid: Influence on the

outcome of pregnancy. Am J Clin Nutr 2000;71(5

Suppl):1295S-1303S.

Robertson EF, Haan EA, Ranieri E, Keane RJ. The

sensitivity of ultrasound and alpha fetoprotein in population

based antenatal screening for neural tube defect, South

Australia 1996-1991. Br J Obstet Gynecol 1995;102:370-6.

Wald NJ, Law M, Jordan R. Folic Acid food fortification to

prevent neural tube defects. Lancet 1998;351:834.

Vaishnav A, Freeman NV, Patton MA. Neural tube defects

and congenital hydrocephalus in the sultanate of Oman. J

Trop Pediatric 1998;44:300-3.

Rasmussen LB, Andersen NL, Andersson G, Lange AP,

Rasmussen K, Skak-Iversen L, Skovby F, et al. Folates and

nural tube defects, Recommendations from a Danish working

group. Dan Med Bull 1998;45:213-17.

Michie CA, Chambers J, Abramsky L, Kooner JS. Folate

deficiency, neural tube defects and cardiac disease in U.K

Indian and Pakistanis. Lancet 1998;351:1105-7.

Chan A. Robertson EF, Haan EA, Ranieri E, Keane RJ. The

sensitivity of ultrasound and alpha fetoprotein and population

based antenatal screening for neural tube defect, South

Australia 1991-1996. Br J Obstet Gynaecol 1995;102:370-6.

Rothenberg SP, Costa MP, Sequeira JM, Cracco J, Roberts

JL, Weedon J, et al. Auto antibodies against folate receptors in

women with a pregnancy complicated neural tube defect. N Engl

J Med 2004;350:134-42.

Padmanabham L. Ahmed I. Sodium volproate augments

spontaneous neural tube defects. Reported Toxicol

;10:345-63.

Li Z, Ginder J, Wang H, Berry RJ, Li S, Zheng JC, et al.

Folic acid supplements during early pregnancy and likelihood

of multiple births: a population-based cohort study. Lancet

;361:380-4.

Tahir S, Aleem M, Salam F. Prevalence and management of

anencephaly at Divisional Headquarter Hospital Faisalabad.

Pak J Med Sci 2002;18:302-5.

Dolk H, Dewals P, Ygiverot M, Flechat M, Ayme S, Carnel

A, et al . Heterogenicity of NTDs in Europe. The significance

of sight of effect and presence of other major anomalies in

relation to geographic differences in prevalence. Teratology

;44:547-59.

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Published

2010-12-01

How to Cite

Khattak, S. T., Khan, M., Naheed, T., Khattak, I. ud D., & Ismail, M. (2010). PREVALENCE AND MANAGEMENT OF ANENCEPHALY AT SAIDU TEACHING HOSPITAL, SWAT. Journal of Ayub Medical College Abbottabad, 22(4), 61–63. Retrieved from https://demo.ayubmed.edu.pk/index.php/jamc/article/view/2710

Issue

Vol. 22 No. 4 (2010): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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