Approval was taken from the Institutional Human Ethics Committee before the commencement of the study. Written expressed consent was taken from the parents. The babies were thoroughly evaluated to identify the nature, severity of structural congenital malformations and to classify them as single or multiple malformation syndrome or associations. Appropriate investigations and treatment were provided to neonates who required them.

Inclusion Criteria

1. Patients diagnosed with congenital malformed fetus irrespective of gestational age and time of presentation (i.e. antenatal, during labor, or post part Partum period)
2. All babies with congenital malformations diagnosed before, at, and after birth i.e. In- utero, Intra Partum and Post-Partum.

Exclusion criteria

1. All intrinsic anomalies e.g of the cardio-vascular system are excluded which are not grossly apparent.

Invasive Procedure

1. MTP (Medical Termination of pregnancy)
2. Induction of labor
3. Normal Vaginal delivery with or without episiotomy
4. Cesarean section

Statistical analysis

The data was coded and entered into a Microsoft Excel spreadsheet. The analysis was done using SPSS version 15 (SPSS Inc. Chicago, IL, USA) Windows software program. The variables were assessed for normality using the Kolmogorov-Smirnov test. Descriptive statistics were calculated.

CNS MALFORMATIONS

Fig-3: Exencephaly with cleft lip and cleft palate at 30.3 weeks gestation.

Fig-4: Hydrocephalus with intra uterine fetal death presenting in obstructed labour at 36 weeks of gestation.

Fig-5: Cleft lip, cleft palate with congenital icthyosis at 37 weeks of gestation.

Figure 6 explains the distribution of Congenital anomalies of the study participants.

• 30 % of participants had Hydrocephalous, 10% had Anencephaly, while 10% of Hydrocephalus with polycystic kidney, 10 % Arnold Chiari 2 malformation with spina bifida with meningocele, 10% Enencephaly, 10% cleft lip with cleft palate with omphalocele with the imperforated anus, 10% cleft lip cleft palate with congenital ichthyosis, 10 % exencephaly with cleft lip cleft palate respectively.

Table-4: Distribution of study participants according to time of detection.

• The mean time of detection calculated is 22.3 years of presentation with maximum time being 37 weeks years and minimum time being 19.3weeks.

Table-5: Distribution of study participants according to the presence of gross anomalies.

Table 5 describes the distribution of study participants according to the presence of gross anomalies.

• Most of the participants 80% had gross anomalies while 20% did not have gross anomalies.

Table-6: Distribution of study participants according to consanguineous marriage.

Table 6 explains the distribution of study participants according to consanguineous marriage.

• Most of the participants (60%) had Consanguineous marriage while 40% did not have a consanguineous marriage.

Table-7: Distribution of study participants according to anomaly scan.

These malformations account for 3% of “major” structural defects, and 15% of “minor” anomalies [6].

The present cross-sectional study was performed on 10 patients diagnosed with having congenital malformed fetuses at tertiary care center- G.K. General Hospital, Bhuj, Gujarat, India over three months – January, February, and March 2019.

The mean age calculated is 22.3 years of presentation with the maximum age being 26 years and the minimum age being 20 years. Similar results are obtained by Dr. Taksande A et al and Arjun Singh, et al [2,7]. Though most of the studies stated that parity of the mother does not seem to influence the incidence of congenital anomalies a higher percentage of congenital anomalies were seen in the birth order of 1 in the present study this is similar to other studies like Swain et al, R. Kulsherestha et al, Chathurvedi et al, and Grover N. et al [8-11].

Thirty percent of participants were hydrocephalous, 10% were of enencephaly, while 10% of Hydrocephalus with polycystic kidney, 10 % Arnold Chiari 2 malformation with spina bifida with meningocele, 10% Enencephaly, 10% cleft lip with cleft palate with omphalocele with the imperforated anus, 10% cleft lip cleft palate with congenital ichthyosis, 10 % exencephaly with cleft lip cleft palate respectively.

This type of frequency was also reported by Swain et al, Gupth S et al, Kalaiselvan G et al and Pandya M et al [8,12,13,14]. Fifty percentages of participants had terminated pregnancy with PTVD SB, while 10% had second trimester MTP, 10% of neonates lived, 10% died,10% died after three days and 10% had IUFD.

Social awareness about consanguinity and if unavoidable, genetic counseling is important to measure what can be done to reduce the consanguinity.

Congenital anomalies were in babies to mothers between 20-30 years of age. Once an anomaly is detected, various management options are to be discussed with the patients in consultation with a neonatologist, pediatric surgeon, and neurosurgeon when necessary. If parents are willing to continue the pregnancy with compatible congenital anomalies in the baby then pregnancy may be continued.