Incidence of associated systemic anomalies in foetuses with neural tube defect in Uttarakhand population

• Author Details:   
• Roli Joshi ^*
• Sonali Thomas
• Deepa Deopa

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Background: Uttarakhand is a hilly area and females from the interior region 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, among which Anencephaly is common. This lethal neural tube defect results in defective closure of the rostral pore of the neural tube. Neural tube defect is 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, affected by maternal age, birth order, and sex of the fetus in the Uttarakhand population.

Materials and Methods: 21 anencephalic fetuses were collected from the labor room of Government Medical College, Haldwani after permission from the college ethical committee and consent from the guardians of all fetuses, the study was done for the periods of two years, gross features, and systemic anomalies after autopsy, and histological reading was done, fetuses were tabulated according to gestational age and gender. A vigorous maternal history was noted.

Results: Out of 21 cases, 11 anencephalic cases have systemic anomalies, maximum female fetuses were associated with skeletal anomalies meningomyelocele, gastrointestinal anomalies followed by polycystic kidney disease mainly observed in primigravida, prevalence more in females less than 20 years or more than 36 years of age, not having previous anencephalic aborted fetus, intake of folic acid and suffering from any diseases.

Conclusion: Parenteral counseling and antenatal visits, routine tests, and USG must be advised and folic acid supplements must be provided to pregnant females.

Keywords: Anencephaly, Fetal autopsy, Neural tube defects, Polycystic kidney disease.