Termination of Pregnancy for Ultrasound diagnosed Major Fetal Anomalies at a Nigerian Tertiary Hospital: An Initial Experience.

BACKGOUND: Major Congenital anomalies are conditions that are severe enough to reduce life expectancy or compromise normal function. The introduction of prenatal screening for fetal anomalies to mid-trimester ultrasonography allows for early detection of many anomalies including the major ones. Once the diagnosis is made, the parents have the options of either terminating or continuing with the pregnancy after proper counselling. The purpose of this study is to determine the pattern of pregnancy termination for major congenital anomalies in our hospital after seven years of commencement of the screening programme.

METHODS

This was a retrospective study in which all women who presented for prenatal ultrasound screening for fetal anomalies at the University College Hospital, Ibadan, Nigeria between August 2012 and July 2019 were scanned. Those with ultrasound diagnosed major fetal anomalies were counselled on the severity of the anomalies and were given the options of either continuing with the pregnancy or terminating it. All the data were recorded in a spreadsheet while Statistical analysis was performed using the IBM-SPSS version 20 spreadsheet.

RESULTS

During the seven-year period, three thousand, one hundred and twenty (3,120) fetuses were screened for fetal anomalies, out of which sixty-one (1.95%) had major anomalies. Twenty (32.8%) of the major anomalies were terminated at various stages of pregnancy. Anomalies of the central nervous system and the musculoskeletal system were the most frequently terminated anomalies, each having 8 fetuses. This was followed by anomalies involving more than one system which were diagnosed in 3 of the fetuses. All the mothers were counselled before the termination of the pregnancies. Nineteen (95%) of the anomalies were confirmed after termination.

CONCLUSION

The availability of prenatal ultrasound screening permits precise diagnosis of a range of fetal abnormalities, including those incompatible with life. Therefore, termination of pregnancies with major anomalies significantly contributes to the global decrease in perinatal morbidity and mortality associated with birth defects.