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Korean Journal of Obstetrics & Gynecology 2002;45(1):32-44.
Published online January 1, 2002.
Clinical Analysis of Fetal Congenital Anomalies.
Jong Soo Kim, Kyung Sim Koh, Choong Hak Park, Keon Jin
1Department of Obstetrics and Gynecology, College of Medicine, Dankook University, Cheonan, Korea.
2Mei Obstetrics and Gynecology Clinic, Kyunggi, Korea.
Abstract
The term congenital anomalies here refers to structural defect (congenital malformations, deformations, disruptions and dysplasias), chromosomal abnormalities, inborn errors of metabolism and hereditary disease. The prevalence of major congenital malformation (i.e., defects either incompatible with life or severe enough to interfere with normal living) is about 2% to 3%. In the past, infection was one of the major cause of perinatal morbidity and mortality, but owing to the development of antibiotics and intensive care, congenital anomalies are becoming a major cause of perinatal morbidity and mortality. Perinatal diagnosis of congenital anomalies is becoming more important because appropriate perinatal care may minimize the effect of congenital anomalies. This report was based on the 234 cases of the congenital anomalies among 8,099 newborns delivered at Dankook University Hospital from Mar. 1st, 1995 to Feb. 28th, 2000. The analyzed results were as follows: 1. The overall incidence of the congenital anomalies was 2.9%. The incidence of congenital anomalies in male newborns (141, 60.2%) was statistically significantly higher than that of female (90, 38.5%) and ambiguous (3, 1.3%). 2. The incidence of the congenital anomalies of 21-25 year old maternal age was the lowest among each other age group. The incidence of this group was 1.6%, of less than 20 year old group was 2.7%, of over 35 year old group was 2.9%. But there was no statistically significant difference among each maternal age groups. 3. There was no statistically significant difference in the incidences of congenital anomalies between parity. 4. The incidence of low-birth weight less than 2,500 g in congenital anomalies was 9.2%, which was 5.1 times higher than that of the more than 2,500 g. 5. The incidence of vertex presentation in congenital anomalies (192, 82.1%) was very high compared to breech presentation (42, 17.9%). 6. In the method of deliveries, vaginal deliveries was 131 cases (56.0%) and cesarean section was 103 cases (44.0%). 7. The incidence of the congenital anomalies in stillbirth was 28.4%, which was 13 times higher than that of the live birth. 8. The perinatal mortality rate in congenital anomalies were 93 cases (39.7%) and stillbirths were 62 cases (28.4%). 9. When classified according to the type of congenital anomalies, the rate of the incidence was 13.3% (31 cases) in central nervous system, 9.4% (22 cases) in neck and face anomaly, 6.8% (16 cases) in cardiac anomaly, 1.3% (3 cases)in pulmonary anomaly, 5.5% (13 cases) in gastrointestinal anomaly, 13.7% (32 cases) in genitourinary anomaly, 18.4% (43 cases) in musculoskeletal anomaly, 9.0% (21 cases) in skin and soft tissue anomaly, 14.1% (33 cases) in multiple anomaly and 5.5% (13 cases) in chromosomal anomaly. The most common major congenital anomalies was hydrocephalus (14 cases, 5.9%) and polycystic kidney (14 cases, 5.9%). The rate of perinatal mortality of the congenital anomalies was 38.5%, particularly it was the highest in the CNS anomalies which were 89.7%, the next 50.0% in cardiopulmonary anomalies.
Key Words: Congenital fetal anomaly, Ultrasonography


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