The Pattern of Congenital Malformations at the Ladoke Akintola University of Technology, Osogbo

Abstract

Summary  Introduction: This retrospective study was designed to determine the pattern and outcome of congenital malformations among paediatric admissions at the Ladoke Akintola University of Technology Teaching Hospital, (LTH), Osogbo, a relatively new tertiary medical centre in southwestern Nigeria.

Materials and Methods: The case notes of children with congenital malformations admitted to the paediatric unit of the hospital between July 1, 2001 and June 30, 2006 were studied. The malformations were classified into organ systems, while recognized syndromes were classified under miscellaneous.

Results: Out of a total of 3,826 paediatric admissions, 53 (1.39 percent) had congenital malformations; 42 (79.2 percent) of them were referred patients and the remaining 11 (20.8 percent) who were inborn, constituted 0.34 percent of 3,264 deliveries in the hospital maternity unit. The commonest malformations recorded were omphalocoele (13.2 percent), Hirschsprung's disease (11.3 percent), cleft lip and palate (11.3 percent) and cyanotic congenital heart diseases (9.4 percent). Nineteen (35.8 percent) of the 53 patients were discharged for follow-up in the paediatric outpatient department of the hospital, 10 (18.9 percent) were referred to other tertiary centres for surgery because of lack of requisite surgical facilities within the hospital, while nine (17.0 percent) were discharged against medical advice (DAMA) at the request of parents. The remaining 15 (28.3 percent) died during the neonatal period.

Conclusion: The present study emphasizes the need for promptness and improvement in the management of simple correctable malformations such as those causing intestinal obstruction, omphalocoele, as well as cleft lip and palate in the tertiary institutions where children with such malformations are often cared for. It is believed that increases in autopsy rates will help in defining the pattern as well as determining the prevalence of congenital malformations in the community.

Keywords: congenital anomalies