Congenital malformation (CM) will begin to emerge as one of the major childhood health problems Treatment and rehabilitation of children with congenital MALFORMATIONS are costly and complete recovery is usually impossible. The aim of this study was to determine frequency of CM in Yazd central city of the Islamic Republic of Iran to find out if there has been any difference in the rate and types of CM in this area. This descriptive-observational study carried on 4800 births delivered at all maternity hospitals in Yazd from October 2003 to June 2004. Prevalence of CM was 2.83% (2.86 % in male and 2.68 % in female) out of the 136 cases 69(51.88%) were males and 64 (48.12%) were females and 3 with ambiguous genitalia. Positive family history of CM in sibling was in only 6 cases (4.41%).Overall, musculoskeletal (0.83%), central nervous system (0.47%) and genital system (0.37%) were accounted as the most common. Frequency of CM was more seen in still birth (12.5%) as in comparison to live birth (2.71%). There was not statistical difference between prevalence of CM and neonatal’s gender, gestational age, birth order and mother’s age, drug ingestion, illness and parental consanguinity. In this study the overall prevalence of congenital malformation among the newborn was higher than those previous reported in Iran and determining the causes of this difference needs more extensive studies.

Introduction: ARMs and associated abnormalities (AA) are one of the most problematic and common entities in pediatric, Surgery A.A recognition for optimal treatment and best recovery and prevention of disability is very important. About 50% of patient with high type and 25% of low type ARM have associated anomalies, some body single and the others multiple combined anomalies (anomalies in urogenital, musculoskeletal, gastrointestinal, cardiovascular and ophthalmic systems). Among these anomalies, sacral anomaly is very important because has direct effect on the function of urogenital and gastrointestinal system. Recognition of incidence of AA can help the physician to choose the best diagnostic and treatment modalities. This descriptive study in 64 patients with ARMs that have been operated at the pediatric surgery ward, Mashhad University, Medical School ITom1995-1998 and followed for 4-7 years.Result: With regard to the results of physical examination, abdominal and chest X-Ray, ultrasonography, Echocardiography and Spinal cord studies (MRI, C.T Scan...), voiding cystourethrogram (VCUG), Intra venouspyeloureterography (LV.U), distal colostogram, and Barium enema, 32 patients (50%) had associated anomalies (follow up period 4 to 7 years) Of 64 patients in this study; 32 cases (50%) had associated anomalies, mostly of urogenital system (31.2%). The prevalence of other associated anomalies were as bellow: Musculoskeletal system (18.6%), Gastro- intestinal tract (14%), Cardio- vascular system (6.2%), Opthalmic system(6.2%), Soft tissue (3%), Skull (3%), Right lung agenesis(1.5%). This studied the frequency of sex and type of LA in our cases. 62.5% were male, 37.5% female and had, 70.3% high type and 23.4% low type LA; 6.25% cloacal type. Conclusion: All newborns should evaluate for normal anus, if has LA, careful assessment of the genital tracts in females and the genitourinary system in all patients is imperative many children with a high LA have associated spinal cord anomalies, particularly tethered cord. Therefor should be better to evaluate with spinal U.S. & MRI. These infants require evaluations for signs of the VACTERL association including careful cardiac assessment. For these patients Urine analysis (UIA) chest X-Ray, ultrasonography, VCUG, Echocardiography, careful follow up is mandatory.