Prevalence and management of anencephaly at Saidu Teaching Hospital, Swat

Anencephaly is a fatal congenital abnormality characterised by absence of cerebral hemisphere and cranial vault. Overall incidence of anencephaly is 3.8-6.0/1,000 births. This study was conducted to determine the prevalence, diagnosis and management of anencephaly in District Swat. This prospective study was carried out over a period of one year from January 2007 to December 2007 at Saidu Teaching Hospital/Saidu Medical College Swat. Pregnant women having foetuses with neural tube defects (NTDs) admitted in Labour Room/Obstetric Ward of the Saidu Teaching Hospital Swat were selected as subjects. Those women who delivered normal babies were taken as control subjects. A proper history was taken from each subject and all the relevant information were recorded on a proforma. A total of 5,560 subjects were included in this study. Out of them, 69 were having NTDs, 63 had anencephaly, 4 had spina bifida, and 2 foetuses were having multiple neural tube defects. Prevalence of anencephaly was 11.33/1000 births and that of spina bifida was 0.72/1000 births. Eighty percent (80%) anencephaly and 50% spina bifida were diagnosed by ultrasonography. Most of the cases (52, 75.36%) were delivered through normal vaginal delivery after induction. Twelve (17.40%) had spontaneous vaginal delivery, 4 (5.80%) had caesarean section, and hysterectomy was done in 1 (1.45%). Anencephaly is common congenital anomaly in Swat. Complications can be prevented by implementing screening program for early diagnosis, treatment, and management. Prevalence can be decreased by folic acid supplementation periconceptionally.