Abstract
Sir.—Kogutt and Young described a newborn with multiple congenital anomalies as having a case of the fetal hydantoin syndrome.1 The infant had hypoplastic distal phalanges and hypoplastic fingernails, which are common manifestations of the fetal hydantoin syndrome. But the patient also had an imperforate anus, a rectovaginal fistula, renal agenesis, a dislocated hip, multiple rib (and vertebral) anomalies, and a single umbilical artery, which are defects not previously described as part of the fetal hydantoin syndrome. To ascribe the coexistence of those defects and the distal phalangeal hypoplasia to the maternal use of hydantoin seems, at best, controversial. Associations do not make syndromes unless they are commonly, or at least repeatedly, observed.
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