UNSW Embryology

Abnormal Development- Congenital Malformations Classifications

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Introduction

Classification as Major or Minor Abnormality is based on that used by the Australian Institute of Health and Welfare National Perinatal Statistics Unit and published in Congenital Malformations Australia 1981-92.

Major Congenital Malformations

Neural

  • anencephalus
  • spina bifida
  • encephalocele
  • microcephalus
  • hydrocephalus

Cardiovascular

  • transposition of great vessels
  • ventricular septal defect
  • hypoplastic left heart
  • coarctaction of aorta

GIT/Respiratory

  • cleft palate
  • cleft lip
  • oesophageal atresia or stenosis
  • small intestine atresia or stenosis
  • anorectal atresia or stenosis

Renal

  • hypospadias
  • renal agenesis and dysgenesis
  • cystic kidney disease
  • obstructive defects of renal pelvis and ureter

Skeletal/Muscular

  • congenital dislocation of the hip
  • limb reduction defects
  • diaphragmatic hernia
  • exomphalos
  • gastroschisis

Chromosomal

  • trisomy 21 (Down syndrome)
  • trisomy 18 (Edwards syndrome)

Minor Congenital Malformations

Skin

  • skin cysts
  • noncavernous single small hemangioma (<10cm dia.)
  • benign skin neoplasms
  • nevus flammeus
  • birth mark
  • mongolian spots
  • cutis marmorata
  • cafe au lait spots
  • scalp defects, cutis aplasia
  • lanugo excessive or persistent
  • pilonidal or sacral dimple

Skull

  • brachycephaly, dolichocephaly, plagiocephaly
  • craniotabes
  • large, small or absent fontanelles
  • macrocephaly
  • head assymetry

Face

  • facial palsy
  • facial assymetry
  • micrognathia
  • flat or wide nasal bridge, upturned nose, or other minor nose malformations
  • deviation of nasal septum

Eyes

  • estropia, extropia, strabismus
  • nystagmus
  • blue sclera
  • brushfield spots
  • epicanthal folds
  • eye slant (upward or downward)
  • narrow palpebral fissures
  • nasolacrimal duct obstruction/dacryostenosis

 

Ears

  • ear tags
  • bat, cauliflower, elfin, lop, pointed, posteriorly rotated, low-set ears
  • darwins's tubercle
  • preauricular sinus, cyst or pit
  • macrotia

 

Mouth, tongue and palate

  • tongue-tied
  • longue cyst
  • ranula
  • cleft gum
  • macroglossia
  • microglossia
  • nasal teeth
  • big, wide or small lips
  • bifid uvula

 

Neck

  • brachial cleft or sinus
  • redundant neck skin folds
  • webbing of neck
  • short neck

Cardiovascular system

  • patent ductus arteriosus or foramen ovale (gestational age <37 weeks or birthweight <2500g)
  • mild, trivial, or physiological valvular regurgitation
  • cardiomegaly
  • dextroposition of heart
  • heart block
  • persistent fetal circulation
  • single umbilical artery

Gastrointestinal system

  • hepatomegaly
  • splenomegaly
  • meckel's diverticuluum
  • anal tags
  • anal or rectal fissures
  • inguinal hernia in males
  • inguinal hernia in females (birthweight <2500g)
  • umbilical hernia (skin covered) Urogenital system
  • imperforate hymen
  • prominent clitoris
  • fusion of vulva
  • vaginal or hymenal tags
  • cyst of vagina, vulva, canal of Nuck, or ovary
  • hydrocele
  • undescended testes (gestational age <37 weeks or birthweight <2500g)
  • small penis
  • chordee
  • patent urachus or urachal cyst
  • ectopic kidney

 

Limbs

  • skin tags on hands and feet
  • partial syndactyly of toes, webbing of toes
  • bradydactyly, unspecified
  • clinodactyly
  • camptodactyly
  • flexion deformities of digits
  • long fingers and toes
  • nail hypoplasia
  • enlarged or hypertrophic nails
  • widely spaced first and second toes
  • overlapping toes
  • tibial torsion or bowing
  • genuvalgum, varum or recurvatum
  • dislocation of subluxation of knee
  • hallux valgus
  • hallux varus
  • talipes calcaneovalgus, equinovarus
  • cervical rib, other extra ribs
  • rocker-bottom feet
  • simian or Sydney lines, abnormal palmar creases
  • hip subluxation, clicky hips

 

Respiratory system

  • hypoplastic lungs (gestational age <37 weeks)
  • laryngeal stridor
  • laryngomalacia

 

Other conditions

  • balanced autosomal traanslocations
  • birth injuries
  • cephalhaematoma
  • cystic fibrosis
  • enzyme deficiencies
  • hydrops fetalis
  • meconium ileum
  • metabolic disorders
  • pyloric stenosis
  • sternomastoid tumour
  • torticollis
  • volvulus

WHO Definition- Live Birth

Live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective ot the duration of pregancy, which, after separation, breathes or shows evidence of life, such as the beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn.

About Notes

  • Lecture notes from the Embryology course compiled and written by Dr Mark Hill.
  • Original Data source for classifications from Congenital Malformations Australia 1981-1992, P. Lancaster and E. Pedisich, ISSN 1321-8352.

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Date Last Modified: 30/3/99
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