incidence and spectrum of central nervous system malformations in newborns over a decade [2001-2010] in the Central Region of Saudi Arabia

To study the incidence and spectrum of central nervous system [CNS] malformations confirmed by computerized tomography [CT], or magnetic resonance imaging [MRI] in a Saudi newborn population of Riyadh over a 10-year period, and to compare our findings with those in the published literature. This is a retrospective analysis of prospectively collected data on all inborn babies admitted to the Neonatal Intensive Care Unit in Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia that underwent CT or MRI of the brain and spine from January 2001 to December 2010. Out born babies, babies who sustained birth asphyxia, and premature babies were excluded from the study. During the study period, 849 imaging studies were carried out, and from these 248 babies with CNS malformations were identified. Specific syndromes associated with CNS malformations occurred in 58 [23.4%]. Dysraphism was found in 42 babies [16.9%] [25 spinal and 17 cranial]. Hydrocephalus was present in 30 [12.1%], cortical malformations occurred in 31 [12.5%], which was dominated by abnormal cell migration in 20. Cerebellar and posterior fossa abnormalities were diagnosed in 44 [17.7%], Dandy-Walker syndrome in 15, and Joubert syndrome in 12. Prosencephalic pathology was seen in 39 [15.7%], commissural abnormalities in 29, while there was holoprosencephaly in 12. Vascular malformations were found in 4 babies [1.4%]. This study showed a wide spectrum of malformations, with all CNS malformations confirmed by advanced imaging techniques

Pattern of neonatal and postneonatal deaths over a decade [1995-2004] at a Military Hospital in Saudi Arabia

To describe and monitor the causes of neonatal and postneonatal deaths in the Neonatal Intensive Care Unit [NICU] over a 10-year-period. This is a descriptive study of all infants who died in the NICU from January 1995 until December 2004 at Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia. Data were collected prospectively on all infants admitted to NICU. The cause of death for each infant was discussed and determined by at least 2 consultant neonatologists. Deaths were classified according to the modified Wigglesworth's classification of perinatal death. During the study period, there were 79871 live births and 526 deaths, in which 446 84.2% were inborn deaths and 80 15.8% were outborn. Of the inborn deaths, 251 infants died between 1-6 days, 103 died between 7-27 days, and 92 died after 27 days. Lethal malformations led to death in 36%, prematurity and its complications in 42%, hypoxic ischemic encephalopathy in 5%, while other specific diagnoses, combined, led to death in 17% of the cases. Prematurity and its complications followed by congenital malformations were the leading causes of death

Assisted reproductive technology. What is needed in the Kingdom of Saudi Arabia?

In 1978, the first in vitro fertilization baby was born. Since then, we have seen the introduction of several new modalities of assisted reproductive technologies ART, and the spread of ART procedures throughout the world. The number of ART units in the Kingdom of Saudi Arabia is increasing rapidly. The associated complications of ART procedures include fetal, maternal and childhood

Neural tube defect and folic acid

Neural tube defect [NTD] is one of the common serious congenital malformations with an incidence of up to 4.5/1000 live births. Its aetiology and pathogenesis are still unknown. Recent animal studies suggest that it may be due to abnormal homocysteine metabolism. Prevention of NTD by folic acid has been shown to be very effective in recent interventional studies. All women who have previously had an affected fetus/infant should take 1-4 mg of folic acid daily before and during the first trimester of subsequent pregnancies. It is also advisable that all women of childbearing age take 0.4 mg of folic acid daily before becoming pregnant and during the first trimester