Prevalence of Silent Gallstones on Ultrasound in a Nigerian Population.

BACKGROUND: Gallstones detected incidentally during imaging are termed 'silent' or asymptomatic gallstones and they account for 80% of all gallstones. About 1-2% of patients with silent gallstones develop symptoms yearly; however, determining those who will develop symptoms is a major challenge. Ultrasonography is the most sensitive and specific method of detecting gallstones with an accuracy greater than 95%. The study aims to determine the prevalence of ultrasound-diagnosed silent gallstones in a Nigerian population and to determine its association with age and gender. METHODS: This was a retrospective analysis of abdominal ultrasound scans performed at the Radiology department of a tertiary institution between January 2013 and December 2015. Data retrieved included age, sex, and sonographic findings. Data analysis was done by simple proportions and percentages using the Statistical Package for Social Sciences version 20.0 software. RESULTS: Two thousand, one hundred and thirty-eight patients had abdominal ultrasound scans for various reasons during the study period. These included 915 males and 1223 females. Incidental findings of gallstones were observed in 52 patients, giving a prevalence of 2.4%. The prevalence of gallstones increased with age (p=0.051) with the highest prevalence seen in the 5th decade. Gallstones prevalence was higher in females with a male-to-female ratio of 1:3.5. CONCLUSION: The prevalence of silent gallstones is low in our environment, but given the complications that may arise, follow-up for early detection of complications in the patients is therefore strongly recommended.

CONTEXTE: Les calculs biliaires détectés fortuitement lors de l'imagerie sont appelés calculs biliaires "silencieux" ou asymptomatiques et représentent 80% de tous les calculs biliaires. Environ 1 à 2 % des patients atteints de calculs biliaires silencieux développent des symptômes chaque année ; cependant, déterminer ceux qui développeront des symptômes est un défi majeur. L'échographie est la méthode la plus sensible et la plus spécifique pour détecter les calculs biliaires avec une précision supérieure à 95 %. L'étude vise à déterminer la prévalence des calculs biliaires silencieux diagnostiqués par échographie dans une population nigériane et à déterminer son association avec l'âge et le sexe. MÉTHODES: Il s'agit d'une analyse rétrospective des échographies abdominales réalisées au service de radiologie d'un établissement tertiaire entre janvier 2013 et décembre 2015. Les données récupérées comprenaient l'âge, le sexe et les résultats échographiques. L'analyse des données a été faite par proportions et pourcentages simples à l'aide du logiciel Statistical Package for Social Sciences version 20.0. RÉSULTATS: Deux mille cent trente-huit patients ont subi une échographie abdominale pour diverses raisons au cours de la période d'étude. Il s'agissait de 915 hommes et de 1223 femmes. Des calculs biliaires ont été observés chez 52 patients, soit une prévalence de 2,4 %. La prévalence des calculs biliaires augmente avec l'âge (p=0,051), la prévalence la plus élevée étant observée au cours de la cinquième décennie. La prévalence des calculs biliaires était plus élevée chez les femmes avec un ratio homme/femme de 1:3,5. CONCLUSION: La prévalence des calculs biliaires silencieux est faible dans notre environnement, mais compte tenu des complications qui peuvent survenir, un suivi pour la détection précoce des complications chez les patients est donc fortement recommandé. Mots-clés: Calculs biliaires silencieux, Échographie, Nigérian.

Prenatal Screening for Down Syndrome: How Acceptable is it among Pregnant Nigerian Women?

BACKGROUND AND OBJECTIVE: Down syndrome is the most common chromosomal anomaly found among newborns. Prenatal screening can inform pregnant women and their partners of the risk of their baby having Down syndrome. The study aimed to determine the awareness and attitude of Nigerian pregnant women towards prenatal screening for Down syndrome. METHODS: This was a prospective observational study among pregnant women who attended antenatal clinics at two teaching hospitals in Nigeria between January and June 2018. Data on their awareness and attitude towards Down syndrome screening were collected using a semi-structured questionnaire and analysed with SPSS version 23.0. Level of significance was set at p<0.05 and 95% confidence interval (CI). RESULTS: Four hundred and four women participated in the study and their mean age was 30.8±4.87 years. Overall, 65.1% were aware of Down syndrome and the media (54.4%) was their main source of information. Less than half (44.3%) of them had a positive attitude towards Down syndrome screening. Respondents with primary (AOR=0.20, 95% CI=1.175-21.687) and secondary education (AOR=0.34, 95% CI=1.494-5.867) were less likely to be aware of Down syndrome, while having a positive attitude towards Down syndrome screening (AOR=2.07, 95% CI=0.314-0.745) and being engaged in skilled occupation (AOR=3.26, 95% CI=0.135-0.697) predicted awareness. A positive attitude towards Down syndrome screening was predicted by being engaged in skilled (AOR=2.51, 95% CI=0.185-0.858) and semi-skilled (AOR=2.37, 95% CI=0.205-0.870) occupation. CONCLUSION: Though majority of pregnant women had good awareness of Down syndrome; however, less than half of them had a positive attitude towards the screening test. The awareness and positive attitude exhibited by the women in this study were influenced by their level of education and occupation.

CONTEXTE ET OBJECTIF: Le syndrome de Down est l'anomalie chromosomique la plus fréquente chez les nouveau-nés. Le dépistage prénatal peut informer les femmes enceintes et leurs partenaires du risque que leur bébé soit atteint du syndrome de Down. L'étude visait à déterminer la sensibilisation et l'attitude des femmes enceintes nigérianes à l'égard du dépistage prénatal du syndrome de Down. MÉTHODES: Il s'agissait d'une étude observationnelle prospective parmi les femmes enceintes qui ont fréquenté les cliniques prénatales de deux hôpitaux universitaires au Nigéria entre janvier et juin 2018. Les données sur leur sensibilisation et leur attitude à l'égard du dépistage du syndrome de Down ont été recueillies à l'aide d'un questionnaire semi-structuré et analysées avec SPSS version 23.0. Le niveau de signification a été fixé à p<0,05 et à un intervalle de confiance (IC) de 95%. RÉSULTATS: Quatre cent quatre femmes ont participé à l'étude et leur âge moyen était de 30,8±4,87 ans. Dans l'ensemble, 65,1 % d'entre elles connaissaient le syndrome de Down et les médias (54,4%) étaient leur principale source d'information. Moins de la moitié (44,3%) d'entre eux avaient une attitude positive à l'égard du dépistage du syndrome de Down. Les répondants ayant suivi un enseignement primaire (AOR=0,20, IC 95 %=1,175-21,687) et secondaire (AOR=0,34, IC 95 %=1,494-5,867) étaient moins susceptibles de connaître le syndrome de Down, tandis qu'une attitude positive à l'égard du dépistage du syndrome de Down (AOR=2,07, IC 95 %=0,314-0,745) et l'exercice d'une activité professionnelle qualifiée (AOR=3,26, IC 95 %=0,135-0,697) étaient des facteurs prédictifs de la connaissance du syndrome de Down. Une attitude positive à l'égard du dépistage du syndrome de Down était prédite par l'exercice d'une profession qualifiée (AOR=2,51, IC à 95 %=0,185-0,858) et semiqualifiée (AOR=2,37, IC à 95 %=0,205-0,870). CONCLUSION: Bien que la majorité des femmes enceintes aient une bonne connaissance du syndrome de Down, moins de la moitié d'entre elles ont une attitude positive à l'égard du test de dépistage. La connaissance et l'attitude positive des femmes de cette étude ont été influencées par leur niveau d'éducation et leur profession. Mots-clés: Syndrome de Down ; Connaissance, Attitude, Test de dépistage, Femmes enceintes.

RETROSPECTIVE EVALUATION OF MRI PATTERN OF GLIOBLASTOMA IN A TERTIARY HOSPITAL IN NIGERIA.

Introduction: Malignant gliomas, especially glioblastomas, are among the most aggressive and devastating of cancers, commonly producing profound progressive disability and leading to death in most cases. Conventional magnetic resonance (MR) imaging with gadolinium-based contrast agents is the most widely established and most useful tool in the characterization of cerebral tumors including Glioblastomas. This study aims to describe the imaging characteristics of Glioblastoma in African patients using conventional MR imaging. Methodology: This was a retrospective cross-sectional study carried out at a Nigerian tertiary hospital. The demographic data, MR images and reports of patients with imaging and histological diagnosis of Glioblastoma between January 2003 and September 2017 were retrieved and reviewed. All the recorded data were analyzed using simple proportion and descriptive statistics with the Statistical Package for Social Sciences (SPSS) version 20.0 software for Windows. Results: One hundred and twenty-two (122) patients had brain tumors during the review period, out of which 14 (11.5%) had histologically confirmed glioblastoma. The male- to -female ratio was 2.5 to 1.0. The age ranged between 14 and 72 years with a mean age of 49.6 years SD ±16.3. Twelve (85.7%) patients had solitary tumors and 2 (14.3%) had multiple tumors. Six (42.9%) were found on the right hemisphere only, 5 (35.7%) were found on the left hemisphere while 3 (21.4%) traversed both hemispheres. All tumors showed inhomogeneous enhancement and significant midline shift to the contra-lateral side of greater than 3mm. Only 1 (7.1%) tumor showed evidence of intra-tumoral bleed detected on T2* sequence. Conclusion: Glioblastoma is a known aggressive brain tumor with unique MR imaging characteristics. While midline shift is typical, intra-tumoral bleeding may be an uncommon finding at presentation in our center.

Fetal echocardiography audit in a tertiary hospital in Ibadan, Nigeria

Delayed detection of congenital heart diseases in low- and middle-income countries (LMICs) contributes to the poor outcome of infants with cardiac anomalies. Fetal echocardiography (FE) can detect heart defects in-utero as early as the 18th gestational week (GA), giving parents and medical professionals time to prepare for the baby's delivery and appropriate treatment. University College Hospital, Nigeria, is one of the few centres in Nigeria where FE is performed. Objectives: To examine the indications for referral for FE and the diagnoses made in our first four years of performing FE. Methods: FE was performed in the antenatal clinic of the University College Hospital, Ibadan, Nigeria, using the GE Voluson P6 machine with a 2-6-RS probe. Demographic information was obtained from the antenatal clinic records of the women who had FE using a semi-structured questionnaire. FE diagnoses were retrieved from the FE register. Results: A total of 129 women whose records were available were studied. The mean age of the women was 31.7±5.5 years. Forty-two women (32.6%) were referred because of echogenic foci, making this the most common indication for FE. Twenty-nine (22.5%) fetuses had structural heart defects, the most common being Ventricular Septal Defect. Conclusion: There is a need for Obstetricians and Paediatricians to be aware of the indications for fetal echocardiography and refer women appropriately

Sonographic correlations between intravesical prostatic protrusion and bladder outlet obstruction in patients with symptomatic benign prostatic hyperplasia in Ibadan, Nigeria

Evaluating bladder outlet obstruction (BOO) in patients with prostatic enlargement may reflect the severity of the disease and aid in predicting the treatment outcome. Objectives: To determine the sonological correlation between intravesical prostatic protrusion and bladder outlet obstruction in patients with symptomatic benign prostatic enlargement. Methods: This prospective study was conducted over one year at the Department of Radiology, University College Hospital, Ibadan. A transabdominal ultrasound scan of the urinary bladder and prostate gland was carried out on patients with prostatic enlargement and BOO. The intravesical prostatic protrusion, pre-and post-void urine volumes, prostate volume and bladder wall thickness were measured. Results: A total of 132 men aged 43 to 90 years (mean age: 63.8±8.64 years) were studied. The median size of the intravesical prostatic protrusion (IPP) was 7.25 mm (IQR: 0.00 mm; 14.9 mm). The mean prostate volume was 63.3ml±36.0ml. Most subjects (55; 41.7%) had a prostate volume above 60ml, and most patients (101, 77.2%) had bladder wall thickness less than 5mm. The mean bladder wall thickness was 4.26mm±1.54mm. There was a statistically significant correlation between IPP and pre-void urine volume and prostate volume (p = 0.002 and <0.001, respectively). Patients over 70 years had increasing IPP and post-void urine, which lacked statistical significance (p =0.15). Conclusion: The severity of bladder outlet obstruction was reflected in the pre-void urine volume, which correlated with the size of IPP

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.

CONTEXTE: Les anomalies congénitales majeures sont des affections suffisamment graves pour réduire l'espérance de vie ou compromettre le fonctionnement normal. L'introduction du dépistage prénatal des anomalies fœtales à l'échographie à mi-trimestre permet la détection précoce de nombreuses anomalies dont les plus importantes. Une fois le diagnostic posé, les parents ont le choix d'interrompre ou de poursuivre la grossesse après un conseil approprié. Le but de cette étude est de déterminer le modèle d'interruption de grossesse pour les anomalies congénitales majeures dans notre hôpital après sept ans de début du programme de dépistage. MÉTHODES: Il s'agissait d'une étude rétrospective dans laquelle toutes les femmes qui se sont présentées pour un dépistage échographique prénatal d'anomalies fœtales à l'University College Hospital d'Ibadan, au Nigéria entre août 2012 et juillet 2019 ont été scannées. Celles dont l'échographie avait diagnostiqué des anomalies fœtales majeures ont été informées de la gravité des anomalies et ont eu la possibilité de poursuivre la grossesse ou de l'interrompre. Toutes les données ont été enregistrées dans un tableur tandis que l'analyse statistique a été effectuée à l'aide du tableur IBM-SPSS version 20. RÉSULTATS: Au cours de la période de sept ans, trois mille cent vingt (3 120) fœtus ont été dépistés pour des anomalies fœtales, dont soixante et un (1,95 %) avaient des anomalies majeures. Vingt (32,8%) des anomalies majeures ont été interrompues à divers stades de la grossesse. Les anomalies du système nerveux central et du système musculo-squelettique étaient les anomalies les plus fréquemment terminées, chacune ayant 8 fœtus. Cela a été suivi par des anomalies impliquant plus d'un système qui ont été diagnostiquées chez 3 des fœtus. Toutes les mères ont été conseillées avant l'interruption des grossesses. Dix-neuf (95%) des anomalies ont été confirmées après l'arrêt. CONCLUSION: La disponibilité du dépistage échographique prénatal permet un diagnostic précis d'une gamme d'anomalies fœtales, y compris celles incompatibles avec la vie. Par conséquent, l'interruption de grossesse avec des anomalies majeures contribue de manière significative à la diminution globale de la morbidité et de la mortalité périnatales associées aux malformations congénitales. Mots-clés: Interruption, Grossesse, Anomalies majeures, fœtales, Échographie.

Awareness and Knowledge of Birth Defects among Antenatal Clinic Attendees at the University College Hospital, Ibadan, South-West, Nigeria.

BACKGROUND: The burden of birth defects is disproportionately higher in developing countries. OBJECTIVES: This study assessed the knowledge of risk factors and prevention of birth defects among ante-natal clinic attendees at the University College Hospital, Ibadan, Oyo State, Nigeria. METHODS: This was a cross-sectional study among 415 mothers who presented at the antenatal clinic. A semi-structured questionnaire was used to obtain information on respondents' socio-demographic profile, pregnancy, birth history, knowledge on prevention and risk factors for birth defects. Descriptive statistics was used to present results, independent t-test and ANOVA were used to determine the factors associated with mean of overall knowledge of birth defects. Test statistics was done at a 5% level of statistical significance. RESULTS: The mean age of the women was 31.7 ± 4.8 years. Overall, 93 (22.4%) of the women were above 35 years, 118 (29.9%) were skilled workers and 343 (84.9%) had tertiary education. More than half (219, 52.8%) of the respondents had good knowledge of birth defects (56.4% had good knowledge of prevention and 66.0% had good knowledge of risk factors). Antenatal clinic attendees in their first trimester had higher mean overall knowledge score (8.3 ± 4.9) compared to those in second (7.9 ± 4.5) and third (7.9 ± 4.9) trimesters but this was not statistically significant (p=0.873). However, respondents in skilled/ semi-skilled occupation (8.62) had a significantly higher mean knowledge score compared with those in unskilled occupation/ unemployed (7.33) (p=0.005). CONCLUSION: Knowledge of birth defects is relatively low among women. To reduce the occurrence and severity of birth defects, there is a need to educate mothers on the knowledge, prevention and importance of screening for birth defects.

CONTEXTE: Le fardeau des malformations congénitales est disproportionnellement plus élevé dans les pays en développement. OBJECTIFS: Cette étude a évalué les connaissances sur les facteurs de risque et la prévention des malformations congénitales chez les patientes des consultations prénatales de l'University College Hospital, Ibadan, État d'Oyo, Nigéria. MÉTHODES: Il s'agissait d'une étude transversale auprès de 415 mères qui se sont présentées à la clinique prénatale. Un questionnaire semi-structuré a été utilisé pour obtenir des informations sur le profil sociodémographique des répondantes, la grossesse, l'histoire de la naissance, les connaissances sur la prévention et les facteurs de risque de malformations congénitales. Des statistiques descriptives ont été utilisées pour présenter les résultats, un test indépendant et une ANOVA ont été utilisés pour déterminer les facteurs associés à la moyenne de la connaissance globale des malformations congénitales. Les statistiques du test ont été effectuées à un niveau de signification statistique de 5 %. Soins prénatals, Santé de l'enfant, Connaissances. RÉSULTATS: L'âge moyen des femmes était de 31,7 ± 4,8 ans. Dans l'ensemble, 93 (22,4%) des femmes avaient plus de 35 ans, 118 (29,9%) étaient des travailleurs qualifiés et 343 (84,9%) avaient un diplôme de l'enseignement supérieur. Plus de la moitié (219, 52,8%) des répondants avaient une bonne connaissance des malformations congénitales (56,4% avaient une bonne connaissance de la prévention et 66,0% avaient une bonne connaissance des facteurs de risque). Les patientes en consultation prénatale au cours de leur premier trimestre avaient un score de connaissance global moyen plus élevé (8,3 ± 4,9) par rapport à celles des deuxième (7,9 ± 4,5) et troisième (7,9 ± 4,9) trimestres, mais cela n'était pas statistiquement significatif (p = 0,873). Cependant, les répondants exerçant une profession qualifiée/semi-spécialisée (8,62) avaient un score moyen de connaissances significativement plus élevé que ceux exerçant une profession non qualifiée/chômeur (7,33) (p=0,005). CONCLUSION: La connaissance des malformations congénitales est relativement faible chez les femmes. Pour réduire l'occurrence et la gravité des malformations congénitales, il est nécessaire d'éduquer les mères sur les connaissances, la prévention et l'importance du dépistage des malformations congénitales. MOTS-CLÉS: Malformations congénitales.

The Imaging Features of Tuberous Sclerosis in African Children:A Pictorial Essay.

Tuberous sclerosis (TS) is a neurocutaneous syndrome with an autosomal dominant inheritance characterized by widespread hamartomas and benign neoplasms distributed in several organs throughout the body. The mean age of presentation is 5 years and the imaging features tend to vary with age. The most commonly affected organs include the brain, skin, retina, kidney, bones, heart and lung. The role of imaging diagnosis and management cannot be overemphasized. The aim of this paper is to highlight the specific imaging features of TS in children of African descent which is crucial to timely diagnosis and contribute to improving the outcome of the disease by avoiding common diagnostic pitfalls.

INITIAL EXPERIENCE WITH 3D-ULTRASOUND AS AN ADJUNCT TO 2DULTRASOUND IN FETAL ANOMALY DIAGNOSIS IN A NIGERIAN DIAGNOSTIC FACILITY.

INTRODUCTION: Two-Dimensional ultrasound (2DUS) has been the preferred screening method for fetal abnormalities for several decades. Three-dimensional ultrasound (3DUS) is a technique that converts standard 2D grayscale ultrasound images into a volumetric dataset which allows visualization of the fetus in all three dimensions at the same time. It provides an improved overview and a more clearly defined demonstration of adjusted anatomical planes. The use of 3D imaging is however limited to being an adjunct to 2DUS in the visualization of fetal anomalies. The objective of this study is to highlight the importance of adding three-dimensional ultrasound (3DUS) to two-dimensional ultrasound (2DUS) during fetal anomaly screening. METHODOLOGY: This is a descriptive study conducted at a private fetal diagnostic center, in Nigeria between January 2014 and December 2016. The diagnosis of fetal anomalies was first made with 2DUS after which they were evaluated with 3D ultrasound images displayed on the monitor. RESULTS: Nine fetuses with various fetal anomalies diagnosed on 2DUS were selected for further evaluation with 3DUS. These anomalies include a neck mass, lumbar spinal abnormality, bilateral cleft lip, thanatophoric dysplasia, anencephaly, omphalocele, posterior urethral valve with anhydramnios and ambiguous genitalia diagnosed. These anomalies were better demonstrated on 3DUS. CONCLUSION: 2DUS remains the mainstay imaging modality in screening for fetal anomalies. However, 3DUS may complement 2DUS by allowing better delineation of anomalies and gives the parents a better visualization and understanding of identified anomalies, thereby assisting in informed decision making.

LATE THIRD TRIMESTER ULTRASOUND DIAGNOSIS OF DUODENAL ATRESIA - THE IMPORTANCE OF DETAILED PRENATAL ULTRASOUND SCREENING.

Duodenal atresia (DA) is the commonest type of congenital small bowel obstruction usually presenting in the neonatal period. About half of fetuses with duodenal atresia have other associated anomalies, and these associations often contribute to morbidity and mortality. DA can be fatal unless promptly diagnosed and treated surgically. In experienced hands and in countries where prenatal ultrasound screening for anomalies is routine, DA can be confidently diagnosed prenatally, which can help in reducing the perinatal morbidity and mortality associated with diagnosis after delivery. We report a case of DA diagnosed by ultrasonography at 36 weeks gestation in a 34 year old multiparous woman in a hospital where targeted prenatal ultrasound screening for fetal anomalies was recently introduced, and reviewed relevant literature.

Pattern and outcome of prenatally diagnosed major congenital anomalies at a Nigerian Tertiary Hospital.

INTRODUCTION: The prevalence of major congenital anomalies (CAs) shows wide variations depending on geographical location and may range from <1% to 8% and it causes between 20% and 30% of perinatal deaths. In Nigeria, the prevalence of CAs may be underestimated with the general reliance on mostly livebirths ranging between 0.5% and 2.8% exempting cases of miscarriage and abortions. The purpose of this study was to determine the epidemiologic pattern and outcome of major CAs detected prenatally at the University College Hospital, Ibadan, Nigeria, over a 4-year period. METHODS: This hospital-based descriptive study highlights the prevalence and pattern of prenatally diagnosed fetal anomalies among the pregnant women who presented for routine prenatal ultrasound screening within the study period. Demographic details, associated risk factors, and fetal anomaly type in the fetuses were recorded using a prepared pro forma and were analyzed. RESULTS: Prenatal ultrasound screening for fetal anomalies was performed on 989 fetuses (including 15 sets of twins and 1 set of triplets) during the study period, out of which 62 (6.3%) had CAs. Of the 62 with CAs, 37 (59.7%) were major and 25 (40.3%) were minor. Majority of the fetuses with major anomalies were found among women aged 30-34 years and most were detected during the routine 18-22 weeks' anomaly scan. The major anomalies were most common in central nervous system. Nine (14.5%) pregnancies were terminated before term and 8 (29.6%) babies had different postnatal surgical interventions. Eleven (17.7%) of the fetuses with anomalies died in the perinatal period. CONCLUSION: CAs remain a major contributor to perinatal morbidity and mortality in Nigeria. Since most are idiopathic, early prenatal detection with ultrasound may facilitate improved diagnosis and the reduction of overall perinatal morbidity and mortality in the Nigerian setting.

Routine prenatal ultrasound anomaly screening program in a Nigerian university hospital: Redefining obstetrics practice in a developing African country.

BACKGROUND: Congenital anomalies are among the leading causes of fetal and infant morbidity and mortality worldwide. Prenatal ultrasound (US) screening has become an essential part of antenatal care in the developed world. Such practice is just evolving in the developing countries such as Nigeria. The aim of this article is to present our initial experience and demonstrate the effectiveness of a prenatal US screening program in detecting congenital malformation in a developing country. MATERIALS AND METHODS: This was a prospective evaluation of the prenatal US screenings conducted at a major referral hospital in Southwestern Nigeria. All pregnant women referred to the antenatal clinic for mid-trimester screening during the period of study were assessed. RESULTS: Two hundred and eighty-seven pregnant women (5 with twin gestations) were presented for fetal anomaly scan during the study period. Twenty-nine anomalies (9.9%) were detected among the scanned population. Sixteen of the anomalies were followed to delivery/termination with a specificity of 93.5%. The commonest malformations were demonstrated in the genitourinary tract (34.5%) followed by malformations within the central nervous system (27.6%). Six (20.6%) of the anomalies were lethal. Five of the anomalies were surgically correctable. CONCLUSION: Institutions and hospitals across Nigeria and other low- and middle-income countries need to develop policies and programs that would incorporate a standardized routine screening prenatal US in order to improve feto-maternal well-being and reduce the high perinatal mortality and morbidity in developing nations.