Pattern and Outcomes of Fetal Congenital Anomalies: A Prospective Study at a Tertiary Care Center in Nanded

Background: Congenital anomalies contribute are a major cause of fetal loss, stillbirth, neonatal mortality, and long-term disability. The causes are multifactorial, involving genetic, chromosomal, nutritional, environmental factors and maternal medical conditions. In resource-limited settings, delayed diagnosis worsens outcomes. Timely identification through screening programs enables better clinical decision-making. Methods: This prospective observational study was carried out at a tertiary care center over 18 months (January 2024 to June 2025). A total of 144 antenatal cases diagnosed with congenital anomalies were included. Data on maternal risk factors, gestational age at diagnosis, anomaly type, diagnostic methods, and outcomes were analyzed using descriptive statistics. Results: Ultrasonography was the primary diagnostic modality (73.00%). The majority of anomalies (42.36%) were detected during the 20–24-week period. Central nervous system anomalies were most common (31.94%). Nutritional deficiency was the leading modifiable risk factor (19.44%). Pregnancy outcomes included Medical Termination of Pregnancy (MTP) in 71.53% of cases, live births in 18.05%, and stillbirths in 10.42%. Post-intervention survival among live births was low (6.90% of total study population). Conclusion: Congenital anomalies were characterized by late diagnosis and poor postnatal survival. The concentration of diagnoses within the 20–24-week window highlights a critical “late diagnosis” period that coincides with the upper legal limit for termination, thereby limiting early intervention. Enhancing first-trimester screening (11–14 weeks), improving maternal nutrition, and expanding neonatal surgical and intensive care services are essential.