INCIDENCE AND COUTCOME OF PREGNANCIES WITH NEURAL TUBE DEFECTS IN HMC PESHAWAR

Background: Neural tube defects are common and major birth defects that we see in our hospitals and community.
Factors like geographic conditions, race, sex of the baby and certain maternal conditions affect the incidence of these
defects. This study was carried out to assess the incidence and outcome of neural tube defects in Gynae-C Unit of
Hayatabad Medical Complex, Peshawar.
Material and Methods: It was retrospective study of deliveries at Gynae C Unit of Hayatabad Medical Complex,
Peshawar, from January 2013 to December 2013. Pregnant women delivering babies with Neural tube defects, both
living and dead, were taken into consideration and made part of the study. Their antenatal and postnatal record was
accessed and questionnaires filled accordingly.
Results: During the study period 3350 deliveries occurred, among which 18 were having neural tube defects. Out of
these 8 fetuses had hydrocephalus, 3 had spina bifida with meningiocoele, 2 fetuses were anencephalic whereas 5 had
multiple neural tube defects. During pregnancy the majority of neural tube defects i.e. 67% were diagnosed by ultrasonography.
72% of these ladies had spontaneous vaginal delivery, 11% had vaginal delivery after encephalocentesis
and 6% had caesarean section. Main complication of the condition was polyhydramnios 78% and abruptio placentae
22%. Of 18 women with affected babies, none had taken folic acid in their first trimester.
Conclusion: Neural tube defects are common congenital anomalies in our set up. These can be prevented by health
education of the mothers, regarding pregnancy and the nutritional requirements thereof. Thorough ante natal examinations
can pick up most cases in early stages where management is easier.
Key Words: Neural tube defect, Hydrocephalus, Spina bifida, Meningocoele, Anencephaly