INCIDENCE OF CONGENITAL ANOMALIES IN A NEONATAL INTENSIVE CARE UNIT (NICU)

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Abstract

A one-year study (1985) review showed a high proportion of infants with congenital anomalies admitted to the NICU of our perinatal center. Congenital anomalies were present in 79 (10%) out of 790 admissions.

Classification of the congenital anomalies fell into two groups. 1) Single defect (51%): Deformation-2; Malformation-38 (CSV 12, GU 10, Pulm.7, CNS 6, GI 3). II) Multiple anomalies (49%): Chromosomal-13; Monogenic-11, Unknown-15 (i.e. about 40% of the multiple congenital anomalies could not be diagnosed).

Clinical profile of these infants will be presented in percentage and compared to the overall NICU admission in brackets. 1) Gestational age, range 25-42 wks: preterm 73% [76%]; full-term 27% [24%]. 2) Intrauterine growth retardation in 22% [6%]. 3) Multiple births in 6% [16%]. 4) Fetal anomalies were suspected antenatally in 65%. 5) Delivery by cesarean section occurred in 43% [38%] and was performed primarily for fetal reasons in 74%. Of these, 64% had lethal congenital anomalies, chromosomal disorders or recognized syndromes with grave outcome. 6) Mortality in NICU was 25% [10%]; all of these deaths were attributed to congenital anomalies, none to prematurity. Another 10% [1%] died within the first year after discharge/transfer. 7) These cases accounted for 2580 patient-days (13% of NICU workload).

These findings raise concerns about the perinatal diagnosis and management of neonates with congenital anomalies, particularly those suspected antenatally.

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