Some Congenital Malformations Necessitating Emergency Operations in the Newborn Period

Abstract

The number of infants born with congenital malformations requiring emergency surgery during the newborn period is small—about 2 per 1,000 live births. The cost of treatment of these infants is high, since it necessitates a team of highly specialized and skilled medical and nursing personnel, as well as a great deal of special equipment. Unless these neonates are collected in a few widely separated special centres, doctors and nurses working in neonatal surgical units will not get enough experience in the management of these difficult conditions and will be unable to obtain consistently satisfactory results. By and large this principle has been accepted in Britain. For the general practitioner who delivers an infant with a congenital malformation requiring urgent surgery there are three immediate problems to be solved: diagnosis of the condition, initial management, and management during transport, often over considerable distances. A fourth problem, which is at least as important as the first three, is the support and advice the practitioner has to give to the family of such an infant. In this article common malformations except meningomyelocele and hydrocephalus will be considered; a separate article will deal with these two. © 1971, British Medical Journal Publishing Group. All rights reserved.