To evaluate the clinical and demographic characteristics of the mothers who has pregnancy with congenital anomaly and was terminationed or delivered and to evaluate the incidence, types of anomalies and distribution of anomalies retrospectively in our clinic: 5 years tertiary center experience

Objective: Our aim is to evaluate the clinical and demographic characteristics of the mothers who has pregnancy with congenital anomaly and was terminationed or delivered in Dicle University Faculty of Medicine Obstetrics and Gynecology clinic and to evaluate the incidence, types of anomalies and distribution of anomalies. According to the results to be revealed; It is aimed to contribute to the reduction of perinatal mortality and morbidity, to decrease the serious health expenses caused by congenital anomalies, the effects of psychological, ethical, social traumas that the family and health personnel and to contribute to the management of fetal anomalies. Material and Methods: Patients (n = 834) who were admitted to Dicle University Medical Faculty Gynecology and Obstetrics Clinic between July 2013 and July 2018 (5 years) with a diagnosis of congenital anomaly and terminated or delivered were included in this study. Data of patients such as age, gravida, parity, gestational week, ultrasonographic findings, type of delivery, gestational week at birth, and congenital anomaly type were obtained by examining the hospital information management system archive and the birth books of our clinic. If the gestational week was ≤ 20 week or the weigth of fetus is ≤ 500 gram, pregnancies were accepted as abortion. Minor anomalies and findings (such as choroid plexus cyst, hyperechogenic bowel, short femur, hyperechogenic cardiac focus, mild renal pyelectasis) were excluded from the study. The terminations were done because of the maternal or medical reasons were excluded from the study. Pregnant women with minor anomalies or soft markers but terminated or delivered for different reasons were excluded from the study. Pregnant women who had voluntary abortion without any anomaly were not included the study. Patients whose information could not be obtained from the archive or hospital information management system or incomplete information were excluded from the study. Results: During our study, 834 fetuses with fetal anomalies were delivered. The rate of congenital anomaly in our clinic was determined as 6.12%. When fetal anomalies were evaluated according to system frequencies; SSS anomalies was 426 (51.1%) patients and SSS anomalies was the most common anomalies, skin-lymphatic system anomaly 96 (11.5%), multiple anomalies 87 (10.4%), cardiac anomalies 74 (8,9%), GUS anomalies 59 (7.1%), GIS anomalies 34 (4.1%), musculoskeletal system anomalies 17 (2%), chromosome anomaly 10 (1.2%), chest anomaly 9 (1,1%), cranio-facial anomaly 3 (0.4%) and 18 (2.2%) patients with other anomalies were determined. The most common anomalies as a group; NTD anomalies (n = 199 (23.9%)), hydrocephalus (n = 104, (24.4%)) was the most common isolated anomaly. In the patients with congenital anomalies, the rates of giving birth by cesarean section were higher and this was statistically significant (p <0.001). It was found that there was no relationship between common congenital anomalies and consanguineous marriage or smoking. In our study, it was found that SSS anomalies, skin lymphatic system anomalies and multiple anomalies were observed more frequently in the fetuses of mothers who gave birth before term and this frequency was statistically significant. It was found that SSS anomalies were more common in female fetuses and ambigus genitalia than boys, and this difference was statistically significant (p = 0.037). Conclusion: Early prenatal diagnosis of fetal anomalies and the ability to terminate voluntarily at earlier gestational weeks increased the expectation of pregnant women to give birth to a baby without anomaly and healthy . In addition, it was observed that ethical and psychological acceptability was higher in early terminations. Although there are differences in cultures and laws of countries; We believe that early counseling, especially providing more effective counseling to the family about severe anomalies that are incompatible with life, and the termination option will contribute to the reduction of perinatal mortality and morbidity, and reduce the health expenses and psychological and social traumas that the family will have to experience. It will be one of the important steps to be taken in order to know the distribution and frequency of congenital malformation in every society and even in every region, to determine effective factors and to take preventive measures, to reduce infant mortality and the number of congenitally disabled individuals. Key Words: Congenital Anomaly, Prenatal Diagnosis, Perinatal Morbidity, Perinatal Mortality, Termination.