Prevalencia en malformaciones congénitas diagnosticadas por ultrasonido: tres años de experiencia en una unidad de medicina materno fetal universitaria
Ospina, Luis Alfonso | 2015
Objective: To establish the prevalence of congenital malformations diagnosed in Maternal-Fetal Medicine Unit of Hospital de San José, Bogotá - Colombia and comparing them to national and international reports.
Materials and methods: Retrospective, descriptive observational where the quantification of all malformed fetuses diagnosed in Maternal-Fetal Medicine Unit from June 2010 to June 2013 was performed.
Results: 236 malformed fetuses, a total of 11,914 births, for a prevalence of 1.98 % were included at a mean gestational age at diagnosis of 26.7 weeks (SD 7.1 weeks). The most common congenital malformations were at the level of Central Nervous System (CNS) 88 (37 %) in total and within them, the most prevalent was ventriculomegaly 16 (7 %). Of the 236 malformed fetuses, 165 fetuses (70.2 %) had only one affected system 29 (12.3 %) 2 compromised systems and 42 (17.5 %) over 3 affected systems. Karyotyping was offered to all antenatal patients, however, accepted only 63 (26.7 %), and 39 (62 %) with normal results and the other aneuploidies were found, having Trisomy 21 as the most common. It was possible to establish a concordance of 86% between the antenatal and postnatal diagnosis. The perinatal mortality found in this study was 34.7 %, mainly in fetuses with congenital diaphragmatic hernia 16 cases (88.8 %), fetal non-immune hydrops 8 cases (80%), cardiovascular abnormalities 31 cases (46.2 %) genitourinary and 13 cases (24 %), And fetuses with CNS malformations such as sequence acranea -anencefalia, holoprosencephaly and encephalocele mortality occurred in 100%.
Conclusion: In this study the prevalence of congenital anomalies was found comparable to that reported at local and global levels, which were diagnosed and adequately characterized by more than two-thirds by obstetrical ultrasound performed by trained personnel in prenatal diagnosis. Perinatal morbidity and mortality remain high thoracic, cardiovascular, renal and non-immune hydrops congenital anomalies.