Imperforate anus is a newborn baby genetic problem. A serious one that can't wait.

The fetus breathes in the womb as it grows. It breathes and swallows amniotic fluid and also urinates. But the urine is amniotic fluid. Remember that the fetus is fed and gets oxygen through the umbilical cord. The fetal hemoglobin has a higher oxygen affinity than the mother's hemoglobin, so the fetal blood oxygenates in the placenta. The placenta is like two trees with shared roots. The mother's arteries and capillaries and veins and the fetal arteries, capillaries and veins, all in a close embrace.

The newborn breathes air for the first time at birth and the circulation changes. The blood no longer bypasses the lungs and the lungs inflate. Hopefully. Newborns die if the lungs are unable to inflate.

And the newborn starts eating. Imperforate anus is where the GI tract has not formed correctly. There is no outlet. This is a life or death problem that needs immediate repair.

We examine all newborns. I am a family practice physician and did obstetrics for 19 years. I don't know how many deliveries I did. We are taught a standard pattern of examination of the newborn and that includes looking at the genitals and making sure there is an anus present. In my 25 bed rural hospital, an imperforate anus would mean lifeflight to Seattle or Tacoma, to a big children's hospital. And if there is an imperforate anus, we have to look for other birth defects.

Taken right from

"Some babies with imperforate anus may have problems with their:

Spine, just above the tailbone
Windpipe (trachea)
Tube that connects the mouth to the stomach (esophagus)
Kidneys and bladder
Arms and legs

When a baby has more than 2 of these problems, doctors say they have VACTERL association. Each letter stands for a possible problem:

V = vertebral, problems with the bones in the spine
A = imperforate anus
C = cardiac, problems with the heart
TE = tracheoesophageal fistula and esophageal atresia
R = renal (kidney) problems
L = limb, problems with the bones in the arms"

So imperforate anus is a birth defect. It is not common, but birth defects ARE common: "Every 4 ½ minutes, a baby is born with a birth defect in the United States. That means nearly 120,000 babies are affected by birth defects each year." We check every newborn and then watch them. I have written about a newborn who I sent 250 miles by lifeflight because I was suspicious and couldn't do the next test in a rural hospital. That baby had a major heart defect and had to have surgery.

Parents of a newborn have a grief reaction, a normal response to discovering that their perfect baby is not perfect. Sometimes we see the birth defect ahead of time and they have coped by the time the child is born. I delivered a child with club feet. The family all were prepared and had already chosen the pediatric orthopedist. They said lovingly, "Look, there are the feet we saw on ultrasound!"

I have not seen imperforate anus, but I have seen many other birth defects, from minor to major.

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For reQuest 2019: the reTurn.

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