Delayed referral of congenital anomalies

Abstract

Objective: Standardized international guidelines recommend a routine physical examination of all newborns before discharge, at least within the first 48 hours of life. The aim of this study was to determine the extent of delayed diagnosis in newborns with early detectable congenital anomalies. Material and Methods: Neonates admitted to our pediatric surgery clinic with a diagnosis of congenital anomalies between 2005 and 2010 were retrospectively reviewed. The cohort consisted of patients with imperforate anus, esophageal atresia and congenital abdominal wall defect. A diagnosis made 48 hours or later after birth was considered late diagnosis. Results: A total of 236 newborn patients, requiring surgery for congenital anomalies, were admitted to the clinic during this period. A total of 119 patients had anomalies that would be expected to be diagnosed at an early stage. The diagnosis was delayed in 20.2%. In 8 cases, although the diagnosis was early, the baby was taken home by the family. In total, the diagnosis was not made appropriately and on time in 26.9%. The time of diagnosis was 3-15 days in those with a delayed diagnosis (median 4.5 days). Eleven patients with prenatal diagnosis were diagnosed on time. The inpatient duration and survival rates were not different. Conclusion: Despite the early diagnosis in patients with a prenatal diagnosis, babies who needed a multidisciplinary approach were born in hospitals without newborn or pediatric surgery departments. Diagnostic delays can be reduced by starting an awareness program among health workers for neonatal surgical problems. © 2012 by Türkiye Klinikleri.