Abstract

Aim: Associated anomalies in neonates with congenital anomalies are important reasons of mortality and morbidity in neonatal surgery units. Associated anomalies may be diagnosed with antenatal follow-up. The associated anomalies and their effect on mortality are detected in newborns operated because of congenital anomalies in our clinic.

Materials and Methods: Between January 2000- February 2008 (Term II), 396 newborns with congenital anomalies were detected according to the associated anomalies evaluating protocol of our clinic with physical examination, X-ray, abdominal ultrasound, cardiac examination and chromosome analysis. The main diseases of the surgical newborns, associated anomalies and their effect on mortality were evaluated retrospectively. The rate of additional anomalies; the effect of the additional anomalies and antenatal diagnosis to mortality have been compared to the data of our clinic between 1995-2000 (Term I), and for the significance among the periods Chi-square test has been done by using SPS 16.0.

Results: Of the 396 newborns, 271 had gastrointestinal system anomalies, 51 had respiratory system anomalies, 28 had genitourinary system anomalies and 46 had other system anomalies as the primary disease. In 158 of these newborns (41.4 %) one or more associated anomalies of other systems were determined. But, 14 patients who were died without any attempt because of severe anomalies were left out of assessment. Of the 158 newborns, 57 had cardiovascular anomalies, 38 had genitourinary anomalies, 11 had respiratory system anomalies and 52 had other system anomalies. Of the 117 newborns associated anomalies were diagnosed with antenatal follow-up. One or more system anomalies were accompanied to the primary disease in 61 newborns that were lost during their treatment and 27 of these patients were without antenatal diagnosed. When we compare currently study data (term II) with prior study data (term I), it was seen that associated anomaly increased and antenatal determination decreased mortality and mobidity rates. It was seen that there was a significant increase in term II antenatal determined patients, a significant decrease in associated anomaly born patients, patients died because of this reason and general mortality speed.

Conclusion: One of the factors that effect the mortality and morbidity in newborn surgical neonates is associated anomalies that accompany primary disease. We think that these anomalies’ being recognised with antenatal monitoring and appropriate research protocols can increase the newborns survival ratio with maintaining to determine additional diesases’ treatment possibilities and can decrease general newborn mortality significantly.