Title : Systemic anomalies associated with anencephalic fetuses in pregnant females of interior regions in India
Abstract:
Indian females from the interior and mostly from hilly area are illiterate agricultural laborers. Pregnant females of these distant areas cannot visit for regular antenatal checkups and have folic acids, iron, and vitamins. These deficiencies may lead to neural tube defects, open type its due to defective closure of rostral pore in neural tube and closed- types-failure of secondary neurulation -neural tissue not exposed, among which open type-Anencephaly is common. This lethal neural tube defect results in defective closure of the rostral pore of the neural tube. Neural tube defect is also associated with other 50% of other systemic anomalies. Most of the studies are ultrasonographic but we identified anencephaly grossly and tabulated all associated systemic anomalies. In duration of 5 years of studies 74 dead fetuses were obtained by therapeutic spontaneous abortion among them 21were anencephalic fetuses, after getting permission from the college ethical committee and consent from the guardians of all fetuses. A vigorous maternal history, fetal history, available medical reports was also noted and in fetus gross features, systemic anomalies after autopsy, and histological reading was done, all fetuses as per their anomalies were tabulated according to gestational age and gender. Among 21,11 anencephalic cases had associated systemic anomalies, maximum female fetuses were associated with skeletal anomalies (commonly club foot and polydactyly), meningomyelocele, oral anomalies (cleft lip and palate), gastrointestinal anomalies, pulmonary hypoplasia followed by polycystic kidney disease and cardiac abnormalities. A rare anomaly “Meckel’s Gruber Syndrome” lethal condition was also noticed in one fetus. Anomalies were commonly recorded in primigravida, prevalence was more in females age either less than 20 or more than 36 years with not having history of previous anencephalic aborted fetus, intake of folic acid and suffering from any diseases. Parenteral counseling and antenatal visits, routine tests, and USG must be advised and folic acid supplements must be provided to pregnant females to decrease these incidences.
