OVERVIEW OF ROUTINE ULTRASONOGRAPHY IN DETECTING FETAL ANOMALIES IN A SUBURBAN SETTING IN NIGERIA

Introduction: Fetal structural abnormalities significantly impact the health and well-being of both the fetus and the expectant mother, ranking among the leading causes of perinatal mortality and morbidity worldwide. This study aimed to evaluate the effectiveness of routine prenatal ultrasound scans in detecting fetal anomalies in a suburban setting in Nigeria. Methods: This retrospective study was conducted at a major diagnostic center in southwestern Nigeria from June 2022 to April 2023. Routine prenatal ultrasound scans were evaluated for pregnant women referred predominantly by Traditional Birth Attendants (TBAs). Results: A total of 2,392 pregnant women, including 43 with twin pregnancies, underwent routine prenatal scans during the study period. Among these, 41 anomalies (1.7%) were detected in the scanned low-risk population. However, 45 fetuses were confirmed to have anomalies at delivery or termination, with 7 cases (15.5%) resulting in stillbirths. Most abnormalities (n=37) were identified before 24 weeks of gestation, yielding a sensitivity of 90.2%. The genitourinary tract was the most frequently affected system (39.1%), followed by the central nervous system (21.2%). The specificity of the scans was 99.1%, with one false positive reported. Six anomalies (13.3%) were classified as lethal. Conclusion: Routine prenatal ultrasound scans in suburban settings are effective in detecting fetal anomalies but pose challenges in counseling. The establishment of standardized fetal anomaly detection protocols could help reduce perinatal mortality and morbidity in such settings. Lack of awareness and inadequate funding, particularly among TBAs, remain significant barriers to effective implementation. Keyword: Ultrasound, Prenatal, Fetal Anomaly, Traditional Birth Attendants