Variations in the detection of anorectal anomalies at birth amongst European cities
Autor: | Taieb Chouikh, Andre Cardoso Almeida, Antonino Morabito, Riccardo Coletta, Célia Crétolle, Sotirios Siminas, Bashar Aldeiri, Pietro Bagolan, Marian Knight, Kate Cross, J. Curry, Joseph R. Davidson, Anna-May Long, B.D. Iacobelli, Sabine Sarnacki, Paolo De Coppi, Simon Eaton |
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Rok vydání: | 2019 |
Předmět: |
Male
Paris medicine.medical_specialty Pediatrics anorectal malformations Anorectal anomalies Rome Physical examination 03 medical and health sciences Neonatal Screening 0302 clinical medicine 030225 pediatrics Pediatric surgery pediatric surgery medicine Humans media_common.cataloged_instance Sex Distribution European union Retrospective Studies media_common Missed Diagnosis medicine.diagnostic_test Descriptive statistics business.industry Infant Newborn Infant Retrospective cohort study After discharge medicine.disease United Kingdom Perineum medicine.anatomical_structure postnatal checks Child Preschool congenital anomaly 030220 oncology & carcinogenesis Settore MED/20 Pediatrics Perinatology and Child Health Female Surgery business |
Zdroj: | European Journal of Pediatric Surgery. |
ISSN: | 1439-359X 0939-7248 |
Popis: | Aim: The diagnosis of anorectal malformations (ARM) is made at birth by perineal examination of the newborn, yet small series reported late diagnosis in almost 13%1. No large series to date have looked into the magnitude of missed ARM cases in the neonatal period across Europe. This study aimed to define the rate of missed ARM at birth across four UK and EU centers. Methods: All ARM cases treated at two UK tertiary centers in the past 15 years were compared to two tertiary European centers. Demographic and relevant clinical data were collected. Late diagnosis was defined as any diagnosis made after discharge from the birth unit. Factors associated with late diagnosis were explored with descriptive statistics. Results: Across the four centers (117/1350, 8.7%) were sent home from the birth unit without recognizing the anorectal anomaly. Missed cases showed a slight female predominance (1.3:1), and the majority (113/117, 96.5%) were of the low anomaly with a fistula to the perineum. The rate of missed ARM cases was significantly higher in the UK centers combined (74/415, 17.8%) compared to those in the EU (43/935, 4.6%), (p Conclusion: Significant variation exist between the UK and other European countries in the detection of ARM at birth. We recommend raising the awareness of accurate perineal examination at time of newborn physical examination. We feel this highlights an urgent need for a national initiative to assess and address the timely diagnosis of ARM in the UK. Key words: anorectal malformations, pediatric surgery, postnatal checks, congenital anomaly. |
Databáze: | OpenAIRE |
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