ABSTRACT
Congenital anomalies are one of the leading causes of death in infancy. Not all the disorders producing neonatal respiratory distress are primarily diseases of the lung. So the aim of this work is to find out the spot incidence of extrapulmonary congenital anomalies among neonates with respiratory distress at Sharkia Governorate. For this purpose, all neonates who presented with respiratory distress during a period of one year [from January to December, 1998] were admitted to Neonatal Intensive Care Unit, Pediatric Department, Zagazig University Hospital and were the candidate of this study. Their number was 520 newborn infants, all of them were subjected to full clinical history, thorough clinical examination and the following investigations: complete blood count, blood glucose level, serum calcium level, serum electrolyte, arterial blood gases, chest X-ray and the following investigations were done when indicated, upper gastrointestinal tract [GIT] series with contrast, ultrasonography, CT and Echo- cardiography.The results of this study show that, thirty three out of the 520 neonates with respiratory distress [6.3%] had extrapulmonary congenital anomalies [group I] while the remaining 487 neonates [93.7%] had respiratory distress due to other causes [group II]. In group I, the GIT anomalies were the most common extrapulmonary congenital anomalies with respiratory distress 16/33 [48.50%], while in group II, septicemia with or without bronchopneumonia was the most common cause of neonatal respiratory distress 236/481 [48.5%]. As regards some clinical parameters, we have found that, group I was significantly more common with vaginal deliveries, full term neonates, good moro reflexes, low birth weight neonates, and consanguineous marriages. Whereas group II was significantly more common with caesarian section, premature neonates, poor moro reflexes, normal birth weight neonates and history of maternal drug intake extrapulmonary congenital anomalies are not uncommon causes of neonatal respiratory distress. The diagnosis of these anomalies depends primarily on a high index of suspicion, careful clinical evaluation and if required, investigations according to the suspected anomalies