Gastrointestinal System Anomalies Research Articles

Retrospective Review of Congenital Anomaly Cases in Ruminants

This study was designed to provide data on the incidence rates of congenital anomalies and their distribution by organs and systems in calves, lambs and kids brought to Van Yuzuncu Yil University, Surgery Clinic between 2017-2023. The animal material of the study consisted of 1104 ruminants, including 886 calves, 183 lambs and 35 kids, aged 0-6 months. In addition to clinical examination, anomalies were diagnosed by using direct and indirect radiographic examinations when necessary. In some cases, a definitive diagnosis was made by performing experimental laparotomy based on clinical and radiological examinations. 341 out of 1104 ruminants, including 234 calves, 96 lambs and 11 kids, suffered from congenital anomalies. Of the ruminants with congenital anomalies, 208 (61.00%) were male, 132 (38.70%) female and 1 (0.30%) hermaphrodite. Abdominal wall anomalies were determined with the highest number of 112 (32.9%) cases. These were followed by musculoskeletal system anomalies in 83 (24.4%) cases and gastrointestinal system anomalies in 56 (16.5%) cases. Head region anomalies occurred in 41 cases (12.1%), urinary system anomalies in 23 cases (6.8%) and CNS anomalies in 9 cases (2.6%). Multiple anomalies were recorded in 16 (4.7%) cases. In conclusion, congenital anomalies are frequently seen as pathologies in ruminants in our country, especially in our region. Avoiding inbreeding, making artificial insemination widespread, improving the care and nutrition of the dam during pregnancy, correcting adverse environmental conditions and eliminating stress factors, avoiding over-the-counter medication misuse during pregnancy and most importantly informing field veterinarians and animal owners about the subject will contribute to the prevention of congenital malformations and losses in livestock.

Outcome of Twins Discordant for Major Anomalies

Abstract Objectives This article determines the incidence, management, and outcomes of twins discordant for major structural anomalies. Materials and Methods A retrospective observational study was conducted from 2011 to 2021. Pregnant women discordant for major malformations as confirmed postnatally were included in the study. Demographic and clinical details were collected from medical records. Determining the incidence and profile of twins discordant for major structural anomalies and their management and outcomes were considered as primary objectives that were detailed in dichorionic (DC) and monochorionic (MC) twin pregnancies. Results A total of 83 subjects were included, with an incidence of 1.76% in DC pregnancies and 1.4% in MC pregnancies. Major structural anomalies among DC twins were musculoskeletal (26%), followed by circulatory system anomalies (20.2%), while among MC twins, the majority were found to be central nervous system anomalies (35.7%). Gastrointestinal system anomalies were found the least, with 5.8% in DC anomalous twins, and none were observed in MC anomalous twins. Live birth rate among anomalous twins was found to be 79.71 and 64.29%, and in normal cotwins, it was 92.75 and 85.71% in DC and MC twins, respectively. Surviving anomalous twins underwent postnatal surgery or intervention in 25/69 (36.2%) DC twins, out of which 20 infants were alive and healthy. In the MC anomalous twin group, 3/14 (21.42%) underwent surgical correction; all were alive and well. Postnatally, babies were followed up until 2 years of life. The survival rate for anomalous twins was 47.82% in DC and 35.7% in MC twins. Normal cotwins had overall favorable outcomes, with a survival rate of 89.8 and 85.7% in DC and MC twins, respectively. Conclusion In DC twins discordant for major anomalies, expectant management is a safe option.

Predictors of congenital anomalies among neonates admitted to public hospitals in eastern Ethiopia: a case-control study.

Over 8 million newborns worldwide have congenital anomalies; 3.2 million have resultant disabilities. Ethiopia has a high burden of neonatal congenital anomalies, but research on predictors is limited. This study investigated predictors of neonatal congenital anomalies in eastern Ethiopia. A facility-based unmatched case-control study on 387 mother-infant pairs (129 cases, 258 controls) in public hospitals was conducted. Data were obtained using an interviewer-administered structured questionnaire and a medical record review. Binary logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI) was used to identify predictors of congenital anomaly. Nervous system anomalies were most common 84 (65.1%), followed by gastrointestinal system anomalies 20 (15.5%). Maternal anemia (AOR: 4.37, 95% CI: 2.48-7.69), alcohol consumption during index pregnancy (AOR: 4.01, 95% CI: 1.88-8.54), khat chewing (AOR: 1.73; 95% CI: 1.04-2.85), rural residence (AOR: 1.73, 95% CI: 1.04-2.85) and antenatal care attendance (AOR: 0.43, 95% CI: 0.22-0.84) were significant predictors of congenital anomaly. Several risk factors for congenital anomalies were identified. To reduce risk, antenatal care services should be improved and mothers encouraged to avoid harmful substances during pregnancy and maintain a healthy lifestyle. Intervention strategies are needed to target these risk factors.

Single Umbilical Artery and Associated Systemic Anomalies in Foetal and Perinatal Autopsy: An Observational Study

Introduction: Single Umbilical Artery (SUA) is a congenital anomaly that can occur either as an isolated finding or in association with other systemic anomalies. Several studies have reported that SUA is linked to dysplastic kidneys, ventricular septal defects, oesophageal atresia, spina bifida, diaphragmatic hernia and cystic hygromas. Therefore, investigating cases of SUA in autopsies is crucial. Aim: To estimate the frequency of SUA in foetal autopsies and determine the association between SUA and other systemic anomalies. Materials and Methods: The present ambispective observational study was conducted in the Department of Pathology, Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India, over a 13 year period from January 2009 to December 2021. A total of 63 cases of SUA detected during foetal autopsies were included. Factors such as age, parity and multiple births were collected where available. The hospital-based frequency of SUA was calculated as a percentage. The association between SUA and systemic anomalies was assessed using the Chi-square test. Results: A total of 1338 perinatal autopsies were performed during the study period, with SUA present in 63 (4.70%) cases. The most common associated anomaly was genitourinary defects identified in 16 (25.39%) cases. However, a statistically significant association was observed with musculoskeletal (11.11%), nervous (11.11%), and gastrointestinal system anomalies (19.04%) with a p-value of <0.0001. Conclusion: In the present study, SUA accounted for 4.70% of the foetal autopsies conducted during the study period. The most common associated anomalies were bilateral cystic kidneys, and VATER (Vertebral, Anal, Tracheo-oesophageal, and Renal anomalies) was the most common syndromic associations with SUA.

Comparison of the efficacy of two natural surfactants (BERAKSURF and BLES) in the treatment of respiratory distress syndrome among preterm neonates

BackgroundThe benefit of surfactant replacement therapy for respiratory distress syndrome (RDS) has been demonstrated. However, some surfactants are expensive and usually inaccessible. Consequently, the Iranian Survanta was produced, but its effect on complications and mortality of RDS is unknown. This study aimed to compare the therapeutic outcomes of Iranian surfactant (beraksurf) and BLES (bovine lipid extract surfactant) on RDS treatment among preterm neonates.MethodsThis triple blinded randomized controlled trial study was performed on 128 eligible neonates diagnosed with RDS in Afzalipour hospital in Kerman, Iran. Diagnosis of RDS, gestational age of 28–34 weeks and weight ≥ 1 kg were considered as inclusion criteria. Congenital anomalies such as congenital cyanotic heart diseases, digestive system anomalies and chromosome abnormalities were the exclusion criteria Neonates were randomly assigned into two equal groups: (1) those treated with BLES (n = 64) and (2) those treated with beraksurf (n = 64). Complications including patent ductus arteriosus (PDA), sepsis, intraventricular hemorrhage (IVH), pneumothorax, pulmonary hemorrhage, mortality, and also, the number of days required for invasive mechanical ventilation (using ventilator) and non-invasive continuous positive airway pressure (CPAP) were evaluated for all neonates. The risk ratio (RR) was calculated at 95% of confidence intervals (CI).ResultsCompared with BLES group, the RR estimate among neonates in beraksurf group was 0.89 (0.66–1.20) for PDA, 0.71 (0.23–2.13) for IVH, 0.44 (0.14–1.36) for sepsis, 0.35 (0.13–0.93) for pneumothorax, 0.33 (0.12–0.86) for pulmonary hemorrhage, and 0.55 (0.28–1.05) for mortality.ConclusionsDespite advances in the use of exogenous surfactants for the treatment of neonatal respiratory distress syndrome; There are still some controversial topics in this field. The results obtained in the present study showed that the two types of surfactant (BERAKSURF and BLES) have similar efficacy for the treatment and short-term outcomes in preterm infants with respiratory distress syndrome. Therefore, due to the cost-effectiveness of BRAKSURF compared to BLES, We recommend choosing BERAKSURF in terms of treatment.

Congenital Anomaly Cases in Calves

The purpose of this study was to investigate the prevalence of congenital anomalies in calves brought to the Ondokuz Mayıs University, Faculty of Veterinary Medicine animal hospital surgery clinic between 2010 and 2020. The study material consisted of 140 calves with anomalies of different races and genders. Gender was examined for its effect on the formation of anomaly types and found to be a statistically insignificant factor (P > 0.05). Simmental calves had a statistically significant higher number of digestive system anomaly diagnoses than Holstein calves (P <0.01). Simmental calves were found to have a 2.85 times higher risk of digestive system anomalies than Holstein calves. The predisposition of atresia ani according to race or gender was not statistically significant in digestive system anomalies, but males tended to be more disadvantaged in general. Similarly, it was determined that the gender and race predisposition for atresia coli anomaly was statistically significant (P <0.05), and males were significantly more prone to this anomaly than females by 3.33 times (P <0.05). When musculoskeletal anomalies were compared based on race, the distribution of susceptibility was found to be significant (P <0.01). Simmental and Holstein breeds were shown to have a 5.84 times higher risk than other breeds in this anomaly category, with Simmental breeds having a 5.32 times higher risk than Holsteins in the Samsun region of Turkey. As a result, it was concluded that breed selection is critical in cow breeding to limit the likelihood of congenital abnormalities.

Has the COVID-19 delayed the diagnosis of fetal anomalies and reduced in the follow-up of high-risk pregnancies?

Objective: COVID-19 has deeply affected our lives in terms of social, economic, education and health issues. Pregnant women have had concerns about routine antenatal care visits and decreased follow-up numbers due to concern of COVID-19 transmission. We aimed to evaluate whether there is a delay in the diagnosis of fetal anomaly during the COVID-19 pandemic period and whether patients diagnosed with fetal anomaly attend antenatal care regularly or not, and to investigate the factors that prevent them from regular follow-up. Methods: Pregnant women diagnosed with fetal anomaly during pandemic period (March 1, 2020 to September 1, 2020) and diagnosed with fetal anomaly before pandemic period (September 1, 2019 to February 28, 2020) were compared with a questionnaire in terms of antenatal follow-up frequency and gestational age of fetal anomaly diagnosis. Results: In the during pandemic period group, regular pregnancy follow-up was decreased from 87% to 51% because of maternal anxiety, fear of virus transmission in hospital and the anxiety of passing it on to baby. Attending a detailed ultrasound scan for detecting fetal anomaly at 18–22 weeks was significantly lower in the during pandemic group. In the pandemic period, the most commonly diagnosed fetal anomalies were central and peripheral nervous system, and cardiovascular and gastrointestinal system anomalies similar to the before pandemic period group. The mean frequency of follow-ups in the third trimester in the before pandemic period group and during pandemic period group was 6.02 (±2.36) times and 4.02 (±1.97) times, respectively, and it was a considerable and statistically significant decrease. In addition, the mean week of fetal anomaly diagnosis was 23±6 weeks in during pandemic group, while it was 22±5 weeks in before pandemic group, and there was no statistically significant difference. Conclusion: Antenatal follow-up of the patients has been decreased significantly during the pandemic period, although it does not seem to cause delay in the diagnosis of fetal anomaly. In experienced perinatal centers, if the concerns of patients are relieved and they are examined under suitable conditions for the pandemic, there will be no delay in diagnosis of fetal anomalies.

Ten-Year Survival of Children With Congenital Anomalies: A European Cohort Study.

To investigate the survival up to age 10 for children born alive with a major congenital anomaly (CA). This population-based linked cohort study (EUROlinkCAT) linked data on live births from 2005 to 2014 from 13 European CA registries with mortality data. Pooled Kaplan-Meier survival estimates up to age 10 were calculated for these children (77 054 children with isolated structural anomalies and 4011 children with Down syndrome). The highest mortality of children with isolated structural CAs was within infancy, with survival of 97.3% (95% confidence interval [CI]: 96.6%-98.1%) and 96.9% (95% CI: 96.0%-97.7%) at age 1 and 10, respectively. The 10-year survival exceeded 90% for the majority of specific CAs (27 of 32), with considerable variations between CAs of different severity. Survival of children with a specific isolated anomaly was higher than in all children with the same anomaly when those with associated anomalies were included. For children with Down syndrome, the 10-year survival was significantly higher for those without associated cardiac or digestive system anomalies (97.6%; 95% CI: 96.5%-98.7%) compared with children with Down syndrome associated with a cardiac anomaly (92.3%; 95% CI: 89.4%-95.3%), digestive system anomaly (92.8%; 95% CI: 87.7%-98.2%), or both (88.6%; 95% CI: 83.2%-94.3%). Ten-year survival of children born with congenital anomalies in Western Europe from 2005 to 2014 was relatively high. Reliable information on long-term survival of children born with specific CAs is of major importance for parents of these children and for the health care professionals involved in their care.

Outcome of surgical condition of neonates who underwent surgery: A prospective study from a tertiary care center.

The neonatal period is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra- uterine survival. If the neonate has a coexisting pathology which needs surgery, this challenge is magnified. Neonatal surgical conditions are unique in their type because some require early diagnosis, prompt surgery and postoperative care to improve the survival and outcome. The aim of this study was to know the clinical profile of congenital surgical conditions and to estimate the burden and outcome in special new born care unit. The study population include 138 surgical neonate admitted in special new born care unit, department of paediatrics, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior (M.P.) from April 2017 to April 2018 including six month follow up period. Total admission in special new born care unit were 5378 out of which 138 (2.5%) neonates of surgical condition were admitted in the study period. Incidence of neonatal surgical condition was found to be 8.48%. Surgery was performed in 57 (41.30%) neonates. The Commonest neonatal surgical condition was constituted by gastrointestinal system (39.13%). Among gastrointestinal system anomalies, tracheoesophageal fistula were 28.6% of total gastrointestinal system cases. The most common surgical condition encountered was meningomyelocele, 23.36% of total cases. The survival of neonatal surgical condition in hospital was 52.89% and after six month follow up was 26.08%. The overall mortality with neonatal surgical condition in this study was 73.91%. Maternal age, antenatal care, history of congenital malformation, socioeconomic status, mode of delivery, prematurity, type of admission, single or multiple surgical condition, inotropic and ventilation support, post operative complication were significantly associated with final outcome of neonatal surgical condition. High mortality was found in neonates suffering from surgical conditions. Commonest anomaly includes conditions of gastrointestinal tract. Maternal age more than 35 year, poor antenatal care, prematurity, vaginal delivery, extra mural neonate, multiple surgical condition, inotropic and ventilation support and post operative complications were associated with increased mortality.

Prevalence of Congenital Anomalies in the Northwest of Iran

Prevalence of Congenital Anomalies in the Northwest of Iran

Incidence, spectrum and outcome of congenital anomalies seen in a neonatal intensive care unit in Southern Nigeria.

Congenital anomalies (CAs) refer to defects that are present in a newborn but occurred during intrauterine life. They can be due to genetic, modifiable environmental or multifactorial causes. There was no prior report of their burden in our state. This study aims to describe the incidence, spectrum, predisposing factors and outcome of CAs in our setting. It was a total population study of all neonates with major birth defects admitted into the unit during the study period. Their clinical-demographic features, diagnoses and outcome were entered into an excel sheet. Clinical detection of birth defects was based on standard diagnostic criteria. The data were analysed using IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Patterns and outcome of birth defects were presented as proportions. Selected characteristics were tested for possible association with birth defect using Fisher's exact test. The level of significance was set at P < 0.05. The incidence of major CAs was 4.3/1000 live births. Female neonates were more affected (59.0%). Participants' mean gestational age was 37.7 ± 3.3 weeks. Central nervous system anomalies were the most common (38.5%) birth defects. These were followed by musculoskeletal, body wall and digestive system anomalies: 28.2%, 23.1% and 10.3%, respectively. One-third (33.3%) of the infants had multiple anomalies. Nearly three quarters of them (74.0%) were referred, 18.0% died while 5.0% were discharged alive. A wide range of CAs occur in our setting with dire consequences. Provision of relevant specialised multidisciplinary care is desirable. Furthermore, pubic enlightenment on its modifiable possible causes can reduce the burden.

Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

ABSTRACT INTRODUCTION Newborns in need of surgery are a challenge to manage and require highly specialized centers with multidisciplinary surgical teams. Since the 1980s, neonatal surgical survival has increased by up to 70% in some countries, mainly due to advances in neonatal intensive care, anesthesia and surgical technique. OBJECTIVE Describe surgical case fatality and survival in a neonatal reference hospital in Cuba, estimate risk of death, and identify potential risk predictors among neonatal characteristics. METHODS A retrospective cohort study was conducted based on hospital administrative data and clinical records for a series of surgical cases in the neonatal intensive care unit of Havana’s William Soler University Children’s Hospital from January 2005 to December 2015. All neonates who underwent surgery during the study period were included. The dependent variable was discharge status (alive, deceased); independent variables were: sex, age (in days) at time of surgery, gestational age, birth weight, indication for surgery, surgical order (first, repeat), and presence of sepsis or other postoperative complications. The study used contingency tables to analyze associations between neonatal characteristics and discharge status. A classifi cation tree was used to obtain simple estimates of surgical risk. RESULTS Survival was 91.3% (675/739) among 739 neonates who underwent surgery. The majority were male (58.7%, 434/739), full term (84.2%, 622/739), and of normal birth weight (80.6%, 596/739). Most surgeries were performed in the first 10 days of life. Digestive system anomalies constituted the most common surgical indication (57.6%, 426/739); among these anorectal malformations (26.8%, 114/426) and esophageal atresia (17.4%, 74/426) predominated. Survival rates were lower for digestive perforation (57.7%, 15/26), gastroschisis (57.1%, 4/7) and intestinal atresia (73%, 27/37). Neonates in the youngest and oldest age groups at time of surgery faced highest risk of death, especially those in the older group. Term infants with normal birth weight operated on for the first time had survival rates >95%. CONCLUSIONS Survival was high and low birth weight conferred the worst prognosis. Infants with normal birth weight operated on for the first time had the greatest probability of survival.

Tuvalet Eğitimine Başlamayı ve Tamamlamayı Etkileyen Faktörler

Objective: The aims of this study were to determine the timing of initiation and completion of toilet training (TT) and affecting factors in a group of Turkish children aged 24-60 months. Material and Methods: This survey was performed in an outpatient clinic at Turgut Ozal University Hospital. A questionnaire containing 35 items were applied to the parents who have children aged 24-60 months. The children who couldn't completed TT and had developmental retardation or genitourinary and gastrointestinal system anomalies were excluded. Results: A total of 418 children were taken to the study. Mean the initiation and completion ages were 25.2±5.6 and 27.2±5.8 months, respectively. Mean of TT duration was 56.2±52.5 days. Only 6% of the children were started to the TT at under aged 18 months. Most parents had considered to child's age and readinees for TT. We didn't find any significant association between the age at starting and completion of TT and gender, gestational age, being first born, emplooyed mother, family type, undergoing circumcision, applying reward and punishment during training. Later age of starting and completion TT were associated with higher education level of parents and consulting to an expert during TT. Later age at completion of TT was associated with attending daycare. Conclusion: This study showed that most Turkish families prefer to start on recomended time for the age at initiation of TT and implementing to child-oriented approach in Turkish families.

Kidney anomalies diagnosed by prenatal ultrasound screening and associated non-urinary malformations: a nationwide prevalence study.

To estimate the prevalence of kidney anomalies at second trimester ultrasound screening, and furthermore, to investigate pregnancy outcomes and the pattern of additional malformations. We previously identified all women attending second-trimester ultrasound scans in Denmark between 1 January 2007 and 31 December 2012. Using the Astraia databases and the Danish National Patient Registry, we identified all fetuses with kidney anomalies diagnosed prenatally in these women. In addition to the prevalence of fetuses with kidney anomalies, we estimated the live birth prevalence ratio of non-urinary malformations, comparing the prevalences in infants with and without prenatally diagnosed kidney anomalies. The prevalence of fetuses with kidney anomalies at second trimester scans was 11.4 per 10 000 fetuses. Among the 412 fetuses identified, 127 pregnancies were terminated. For live born children the prevalence of additional non-urinary malformations was four times higher (95% CI: 3-5) compared with the prevalence among children without prenatal kidney anomalies. Digestive system anomalies were particularly prevalent. These population-based data provide additional insight into the course of pregnancy and birth outcomes following prenatal diagnoses of kidney anomalies. © 2016 John Wiley & Sons, Ltd.

A Prospective Study of Spectrum, Risk Factors and Immediate Outcome of Congenital Anomalies in Bida, North Central Nigeria.

Background:Congenital disorders are structural, metabolic, behavioral and functional disorders that are present at birth. Their manifestations are protean ranging from mild anomalies to life-threatening conditions.Aim:The objectives of this study were to describe the congenital anomalies in children seen at Federal Medical Center, Bida over a 12 month period, determine possible factors associated with these anomalies; and their short term outcome.Subjects and Methods:Children with clinically recognized congenital malformations were recruited consecutively over a 12 month period and socio-demographic, etiologic and other relevant clinical data were obtained. A detailed examination was also performed and abnormalities documented. The data was analyzed using Epi-info version 6 (Atlanta, USA). The Chi-square was used to identify significant differences for categorical variables. Mid-P and Fisher's exact tests were utilized as appropriate. A P < 0.05 was considered to be significant.Results:A total of 46 children with congenital anomalies were seen during the study period, all which were recruited into the study. The hospital based prevalence amongst neonates was 111/1000 neonates. The most common system affected was the digestive system(50.0%) followed by the central nervous system and head and neck anomalies. There was no significant difference in distribution of anomalies amongst the various ethnic groups. About 22% of families were consanguineous, all being first cousins and 8.7% of mothers were greater than 35 years of age. The case fatality rate for congenital malformations was 2.2%, while 60.9% were referred to other hospitals for further care.Conclusion:The study has demonstrated a wide variety of congenital anomalies in Bida, North-Central Nigeria with the digestive system anomalies being the most frequent. The findings of this study strengthen the need for empowerment of the institution in appropriate management of these disorders.

Associated congenital anomalies among cases with Down syndrome

Down syndrome (DS) is the most common congenital anomaly widely studied for at least 150 years. However, the type and the frequency of congenital anomalies associated with DS are still controversial. Despite prenatal diagnosis and elective termination of pregnancy for fetal anomalies, in Europe, from 2008 to 2012 the live birth prevalence of DS per 10,000 was 10. 2. The objectives of this study were to examine the major congenital anomalies occurring in infants and fetuses with Down syndrome. The material for this study came from 402,532 consecutive pregnancies of known outcome registered by our registry of congenital anomalies between 1979 and 2008. Four hundred sixty seven (64%) out of the 728 cases with DS registered had at least one major associated congenital anomaly. The most common associated anomalies were cardiac anomalies, 323 cases (44%), followed by digestive system anomalies, 42 cases (6%), musculoskeletal system anomalies, 35 cases (5%), urinary system anomalies, 28 cases (4%), respiratory system anomalies, 13 cases (2%), and other system anomalies, 26 cases (3.6%). Among the cases with DS with congenital heart defects, the most common cardiac anomaly was atrioventricular septal defect (30%) followed by atrial septum defect (25%), ventricular septal defect (22%), patent ductus arteriosus (5%), coarctation of aorta (5%), and tetralogy of Fallot (3%). Among the cases with DS with a digestive system anomaly recorded, duodenal atresia (67%), Hirschsprung disease (14%), and tracheo-esophageal atresia (10%) were the most common. Fourteen (2%) of the cases with DS had an obstructive anomaly of the renal pelvis, including hydronephrosis. The other most common anomalies associated with cases with DS were syndactyly, club foot, polydactyly, limb reduction, cataract, hydrocephaly, cleft palate, hypospadias and diaphragmatic hernia. Many studies to assess the anomalies associated with DS have reported various results. There is no agreement in the literature as to which associated anomalies are most common in cases with DS with associated anomalies. In this study we observed a higher percentage of associated anomalies than in the other reported series as well as an increase in the incidence of duodenal atresia, urinary system anomalies, musculoskeletal system anomalies, and respiratory system anomalies, and a decrease in the incidence of anal atresia, annular pancreas, and limb reduction defects. In conclusion, we observed a high prevalence of total congenital anomalies and specific patterns of malformations associated with Down syndrome which emphasizes the need to evaluate carefully all cases with Down syndrome for possible associated major congenital anomalies.

Hepatic damage in newborns from female rats exposed to the pesticide derivative ethylenethiourea

To evaluate hepatic morphological-histological abnormalities in newborns from female rats exposed to ethylenethiourea. A randomized study was conducted on fifty-five newborn Wistar rats were studied: 34 in the experimental group, whose mothers had been exposed to 1% ethylenethiourea; and 21 in the control group, whose mothers had received 0.9% physiological solution. The solution was administered via gavage on the 11(th) day of gestation. Cesarean section was performed on the 20(th) day of gestation. The newborns' livers were examined and any morphological-histological abnormalities were registered. The presence of megakaryocytes was quantified in 50 microscope fields, as the total number of these cells per mm(2). The entire experimental group presented abnormalities of embryonic formation, with musculoskeletal anomalies, digestive system anomalies, hepatic congestion and friability, hydrops and delayed intrauterine growth. The histopathological analysis showed that morphological-histological hepatic destructuring had occurred in all entire experimental with removal of the hepatic trabeculae and severe hepatic megakaryocytosis. The mean megakaryocyte density ranged from 107.9 to 114.2 per mm(2), and it was eight times greater than in the control group, thus characterizing a situation of extramedullary hematopoiesis. The fetal exposure to ethylenethiourea caused hepatic damage characterized by severe extramedullary hematopoiesis.

Portal vein agenesis: a case report

Portal vein agenesis is a rare malformation. It is seen particularly with cardiovascular and gastrointestinal system anomalies. Radiologic studies of the portal venous system include color Doppler ultrasonography (US), computed tomography (CT), magnetic resonance imaging, and arterial or direct portography. A ten year old child with recurrent abdominal pain because of portal vein agenesis is presented. Keyword: Portal vein agenesis, Abdominal pain

Prevalence of Birth Defects in Korean Livebirths, 2005-2006

We investigated the livebirths prevalence and occurrence pattern of birth defects in Korea. After the survey on birth defects was done in 2,348 medical institutions around the nation, the birth defect prevalence of livebirths in 2005-2006 was calculated. This study was based on the medical insurance claims database of the National Health Insurance Corporation. The number of livebirths in Korea was 883,184 from 2005-2006, and 25,335 cases of birth defects were notified to our study, equivalent to a prevalence of 286.9 per 10,000 livebirths. Anomalies of the circulatory system were the most common defects, accounting for 43.4% of birth defects with a prevalence of 124.5 per 10,000 livebirths. It was followed by the musculoskeletal system anomalies, the digestive system anomalies, and the urinary system anomalies. The five major birth defects based on the ranking of prevalence were atrial septal defect, ventricular septal defect, hydronephrosis, patent ductus arteriosus, and cleft lip/palate. Birth defects in livebirths were associated with a high proportion of low birthweight, prematurity, multiple births and advanced maternal age. The prevalence of birth defects in Korea is similar to or lower than those reported in developed countries. Our study suggests baseline data to explain the current status of birth defects and to establish a registry system of birth defects in Korea.

SP6-63 Analysis of newborn mortality due to congenital anomalies associated with perinatal period risk factors

BackgroundCongenital anomalies play a significant role in perinatal mortality. Congenital anomalies are a cause of death in a third of all babies that die in the first year of life...