Abdul Hamid, Muhammad Javed, Saima Naz.
Frequency, Risk Factors and Types of Cardiovascular Congenital Anomalies in 1000 Live Births.
Ophthalmol Update Jan ;16(2):687-90.

Objectives: This cross sectional study was carried out to know the frequency, risk factors and various types of cardiovascular congenital anomalies (CAs) in 1000 live births at District Peshawar KPK., Material and Methods: The study was carried out in the Gynae and Obstetrics unit in Kulsoom Maternity Home Peshawar, during the study period from 01.10.2016 to 30.09.2017. The study sample included, 1000 pregnant women (both emergency and booked cases) admitted for the purpose of delivery, in the age group between 16 and 45 years. Besides preliminary investigations, all the cases were subjected to ultrasound examination and were examined periodically throughout pregnancy. After the delivery all the live newborns were thoroughly clinically examined for any gross congenital anomalies, especially of the cardiovascular system. Newborns suspected of having congenital anomalies other than the obvious ones, were subjected to ultrasonographic examination of the respective system. Echocardiography was done in newborns suspected of having cardiovascular anomalies (CVAs). Cases with still births, intrauterine deaths and abortions were excluded from the study sample. Results: In the whole study population of 1000 pregnant females, only twelve (12) cases gave birth to newborn with cardiovascular congenital anomalies at the time of birth. Therefore the total incidence/ frequency of CVAs were 1.2%, excluding CAs in stillbirths. CAs were detected in other systems of the body also. Out of 12 cases, of cardiovascular CAs, Ventricular septal defect (VSD) was among the most frequent acyanotic congenital heart defect, constituting 5/12 (41.66%) 0f the total. Other anomalies in descending order of frequency included, ASD (Atrial Septal Defect) Secundum 2/12 (16.66%) while Pulmonary Stenosis (PS), Patent Ductus Arteriosus (PDA), Dextrocardia, Transposition of Great Arteries (TGA) and Tetralogy of Fallot (TOF) contributed to 1/12 (8.33%) each. Various associated risk factors included advanced maternal age, bad obstetrical history, antenatal febrile illnesses, drugs intake during pregnancy, Diabetes, exposure to radiations and poor socioeconomic conditions (deficiency of multivitamins/folic acid). Conclusions: Cardiovascular congenital abnormalities being one of the important causes of increased morbidity and mortality, needs serious attention. Many of the possible risk factors can be avoided. For the safe and sound outcome of pregnancy, regular antenatal checkups are required. The condition can be detected at an early stage in the intrauterine period and possible preventive and curative measures can be taken in time. Therefore, regular and repeated ultrasonic examinations are suggested during pregnancy.

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