CONGENITAL MALFORMATIONS AND OBSTETRICS

[摘要] The existence of a malformation in a fetus is not often associated with abnormalities of pregnancy or labor. The chief concern of the obstetrician is in counseling the parents concerning future childbearing.Malformations were reported by the National Office of Vital Statistics as responsible for 4.4 neonatal deaths per 1000 live births during the first 3 months of 1950. They accounted for 24% of the deaths of infants weighing over 2500 gm; 7% of the deaths of infants weighing under 2500 gm; that were born in the U.S. during this interval.In a study of 5000 consecutive births at the Chicago Lying-in Hospital in 1951 and 1952, 210 surviving infants were found to have certain conditions considered to be malformations. It was thought that not more than 10% of these infants, or 4.2 per 1000 births, would be handicapped by the malformations. Coupling this with the deaths and stillbirths occurring during the same period gives a total of 10.6 per 1000 births. Thus about 1% of reported births are infants with lethal or handicapping malformations which can be diagnosed at or soon after birth.Lethal malformations involved the central nervous system more often than any other part of the body, with anencephaly the most common single anomaly. Cardiac malformations were second, with those of the gastrointestinal and genitourinary tracts about equal in third and fourth places.Malformations occur more commonly in males than females and in white than non-white and in the children of women who are near the beginning or end of the age when reproduction is possible.Genetic disturbances can rarely be shown to be the cause of lethal malformations.

[学科分类] 儿科学