Morphometric characteristics of anencephalic skulls - A comparative study. Anencephaly is the most severe form of a neural tube defect. As desmal ossification of the neurocranium is induced by the presence of soft tissues (brain), no bone develops as direct consequence of the missing brain. However, the cranial base, which is formed by chondral ossification, is present. In this study, the authors assessed macroscopic morphological-anatomical and cephalometric CT data on structures and dimensions of 11 macerated anencephalic and 4 normal neonatal skulls highlighting skeletal morphological differences. The most striking results were the missing skullcap and the greatly changed morphology of the existing skull bones, which were reduced in size. The parameters of the skull base, the transverse orbital diameter and maxillary width were significantly smaller in anencephalic skulls. The morphology of the viscerocranium appeared similar to that of normal neonatal skulls. The results of this study can be used in diagnosis and skeletal classification for anencephaly.
Prevalence and associated factors of birth defects among newborns in sub-Saharan African countries: a systematic review and meta-analysis. Birth defects are the most serious causes of infant mortality and disability in sub-Saharan African countries. Twenty-five studies in 9 countries showed a prevalence of birth defects was 20.40 per 1,000 births (95% CI: 17.04, 23.77). The highest prevalence was observed in southern Africa region with a prevalence of 43 per 1000 (95% CI: 14.89, 71.10). The most prevalent types of birth defects were musculo-skeletal system defects with a pooled prevalence of 3.90 per 1000 (95% CI: 3.11, 4.70); the least was Down syndrome 0.62 per 1000 (95% CI: 0.40, 0.84). Lack of folic acid supplementation (95% CI: 1.95, 7.88), presence of chronic disease (95% CI: 2.00, 6.07) and intake of drugs (95% CI: 3.88, 14.66) during pregnancy were significantly associated with the birth defects.
Neonatal Presentations of Metabolic Disorders. A newborn with a metabolic disorder can present with an acute metabolic crisis such as hyperammonemia or seizures, with a more chronic clinical picture such as cholestatic liver disease, or with structural abnormalities such as skeletal manifestations. Early detection of treatable metabolic conditions is important to improve outcomes. Newborn screening has facilitated early detection and initiation of therapy for many metabolic disorders, but normal screens do not rule out the less common metabolic disorders. A high index of suspicion should remain when caring for any critically ill neonate.
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