Study of Congenital Malformations in Central Nervous System & Gastro-Intestinal Tract

NATIONAL JOURNAL OF MEDICAL RESEARCH
ORIGINAL ARTICLE
STUDY OF CONGENITAL MALFORMATIONS IN CENTRAL

NERVOUS SYSTEM & GASTRO- INTESTINAL TRACT
Saiyad SS1, Jadav Hrishikesh R2
1Professor
& Head, Department of Anatomy, GMERS Medical college, Gandhinagar 2Professor & Head, Department of
Anatomy, GMERS Medical college, Sola , Ahmedabad, Gujarat
Correspondence:
Dr. H. R. Jadav
18/Shivkunj Society, Radhaswami satsang road,
Ranip, Ahmedabad - 382480
E Mail: drhrishihrishihrishi@gmail.com
ABSTRACT
Introduction: Congenital malformations comprise 8% of the perinatal mortality in India. They rank fifth as a cause
of perinatal mortality, after asphyxia, respiratory problems, infections and cerebral trauma. However, the pattern is
changing rapidly with improvement in health care and living standards.
Material & Method: In the present study, authors have tried to study the cases of congenital malformations specially
related to Central nervous system and Gastro-intestinal system. 5240 cases of newborn babies were studied and results
were analyzed and classified in to various categories.
Findings: The results show that malformations are more common in still birth, more in female babies and more in
central nervous system In live born babies the percentage of malformation is0.63 % whereas in still born baby it is6.53 %.
Conclusions: Chances of having malformations increases as the age advances. Parity of mother also influences the
incidence. Exposure to radiation & drugs also influences malformations. Incidence of congenital malformation is highest in
central nervous system.
Key words: Congenital, Malformations, Central Nervous System, Gastro Intestinal Track, Still birth
INTRODUCTION 2. To determine frequency of malformations of these

systems
The study of birth defects has assumed greater
3. To study causative factors - associated with central
importance these days than in the past because the
nervous system and Gastro-intestinal tract anomalies
mortality rates attributed to congenital anomalies have
reduced in comparison to other causes of death such as
infections and nutritional diseases.Large number of
MATERIALS & METHODS
malformations are incompatible with lifeand they
involve one or more systems of the body. It is New born babies delivered in the Department of
estimated that as many as 50% pregnancies terminate as obstetrics and gynaecology of various General Hospitals
miscarriage. In majority of cases this is because of and also treated in the same hospitals including still
faulty development. Experimental teratological study in borns were examined either immediately after birth or
human being is not possible, whereas the same in within 24 hours after birth for any major congenital
animals has advanced phenomenally. As a result of anomaly. Mother was specifically asked about, History of
wide range of information that are now available from trauma, Diabetes mellitus, smoking, alcohol, infection
these experiments, it has become possible to obtain an (viral & bacterial), exposure to radiation, exposure to
insight into the causes, mechanism, and preventions of teratogenic drugs, etc. During examination of baby,
birth defects. However considerable work will be state of birth, weight, height, Head circumference,
required before these problems can be overcome. In associated illness, umbilical cord, and various systems like
present study authors have made an attempt in this respiratory, cardiovascular and central nervous system
direction. were examined thoroughly. Outcome of all the
malformed babies were recorded during the period of
The aim of present study is:
mothers hospital stay.The observations and results were
1. To find out common congenital malformations in noted and presented in tabular form. Ethical committee
Central nervous system and Gastro-intestinal permission was taken.
system
Volume 2 Issue 2 Apr June 2012 print ISSN: 2249 4995 eISSN: 2277 8810 Page 121

OBSERVATIONS & RESULTS show that the incidence was significantly higher in still
born babies. A study conducted in Ajmer by Gupta1 (
In the present study, authors studied total numbers of
1971) , reported congenital malformation 1.9 % in live
5240 deliveries conducted at civil hospital, Ahmedabad.
born where as 20.4% in still born babies, Study by
Out of which 2936 were male & 2304 were female. 5041
Purandare2 (1966) in Mumbai shows live born
were live born & 199 were still born. Out of which 45
malformations to be 1.4 % and still born malformations
babies were having malformations.
9.5%.
Table 1: Incidence rate of various congenital

Table 4: Malformations of different systems
anomalies
Type of Malformation Cases Percentage
Groups Babies Malformed Incidence Central nervous system
Babies (%) Microcephaly 3 10.34
Total Babies 5240 45 0.86 Hydrocephaly 4 13.80
Male babies 2936 17 0.58 Meningocele 2 6.90
Female babies 2304 26 1.13 Spina Bifida 3 10.34
Live born 5041 32 0.63 Enencephaly 12 41.38
babies Encephalocele 2 6.9
Still born 199 13 6.53 Meningomyelocele 3 10.34
babies Gastrointestinal System
Imperforated anus 5 16.67
From table 1 it is seen that malformation is more Anal stenosis 1 3.33
prevalent in live born babies than stillborn. It is also Oesophageal Atresia 2 6.67
more common in female than in male offspring. Cleft palate 7 23.33
Cleft lip 8 26.67
Tracheo- 2 6.67
Table 2: Age distribution of mothers Omphalocele 1 3.33
Age of Mother (Yrs) Babies Malformed Babies (%) Rectovesical Fistula 2 6.67
16-20 1540 13 (0.84) Rectovaginal Fistula 1 3.33
21-25 2847 17 (0.60)
26-30 509 8 (1.57) The values were 1.79 % and 11.4 % by Chandra &
31-35 176 3 (1.70) harilal3 ( 1977)at Madras , 1.4 % and 12.00 % by
36-40 105 2 (1.90) Mathur4 ( 1975 ) in Hyderabad area . In another study
Above 40 63 2 (3.17) carried out by Gupta1 et al the percentage of C.N.S &
Total 5240 45 (0.86) G.I.T malformations were 0.75% & 0.33% respectively.
In study by Purandare2 it was 0.36% & 0.06% , In
Younger age group is also more commonly affected. Mathur4 0.76% & 0.37%, In Saifullah5 it was 1.3% &
Malformation is also more common in primi females. 0.4%, Where as in present study it was 0.49% & 0.4%
respectively. It is seen that babies are born alive with
G.I.T malformations where as most of the C.N.S
malformed babies are born dead, Out of the C.N.S
Table 3: Parity distributions
malformed babies those with anencephaly born dead-
Parity Cases Cases with malformation are 100%. Out of 26 cases of C.N.S malformations, 14
(%) were still born and percentage works out to be 53.85%
I 2899 20 (0.69) and out of 21 cases of G.I.T malformations no still birth
II 791 6 (0.76) was recorded. Chances of giving birth to malformed
III 892 9 (1.01) baby increases as the age of mother advances,
IV 443 6 (1.35) particularly after 40 years As the parity increases the
V 120 2 (1.67) incidence of malformed baby also increase. In fourth
VI 95 2 (2.11) para the incidence is three times more than primi. The
incidence of babies having malformations is definitely
DISCUSSION higher in mothers exposed to radiations during
pregnancy. Chances of malformations also increase in
In the present study, the incidence rate of congenital consanguineous marriage.
malformations was found to be 0.86%. This included
both live, still briths and major malformations. Out of
this, C.N.S malformations were found to be 4.96% and CONCLUSION
G.I.T 4.01%. Further from table-1, it is observed that
malformations are much more common in still births Present study provides us an idea regarding prevalence
(6.53%) as compared to live births (0.63%). Hospital of cases of congenital malformations and factors
based studies carried out in various cities in India, also affecting it , in Indian environment .We can also come

on conclusion that CNS & GIT are two most 3. Chandra P, Harilal KT. Congenital malformations- A study of
commonly affected systems. Factors affecting consecutive births. Abstract from conference (Madurai). Indian
academy of pediatrics Tamilnadu state branch 1977.
development of the embryo should be found & it
should be eliminated during antenatal management. 4. Mathur HC, Sheila karan, Vijaya Devi KK. Study of Congenital
malformations in the newborn. Indian J of Pediatr. 1975;12:179-
83.
REFERENCES 5. Saiffulah S, Chandra RK, Pathak IC, Dhait GI. Congenital

malformations in new born. Indian J of Pediatr. 1967; 4:,251-6
1. Gupta BM, Mathur HC, Sharda DC. A study of congenital
6. Sagunabai NS, Mascarene M, Syamalan K, Nair PM. An
malformations in central Rajasthan (Ajmer) Arch child Health
aetiological study of congenital malformations in new born ,
1971;13:30.
Indian J of Pediatr. 1982;19:1003-7.
2. Purandare VN, Stevenson AC, Johnston HA, Stewart MI,
Golding DR. Congenital malformations - A report of a study of
Congenital births in 24 centres. Bull WHO. 1966; 34 (Suppl):24.

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NATIONAL JOURNAL OF MEDICAL RESEARCH

STUDY OF CONGENITAL MALFORMATIONS IN CENTRAL

INTRODUCTION 2. To determine frequency of malformations of these

Table 1: Incidence rate of various congenital

REFERENCES 5. Saiffulah S, Chandra RK, Pathak IC, Dhait GI. Congenital

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