VACTERL Screening in Newborns With Anorectal Malformations - An Opportunity to Optimize Screening Practices, add Gynecologic and Spinal Conditions, and Utilize a New Acronym: VACTE(G)RLS
Topic overview
Multi-institutional study of 1,467 ARM patients reveals that spinal cord and gynecologic anomalies are frequently underdiagnosed at birth, with detection rates increasing significantly across subsequent encounters. Authors propose expanding VACTERL to VACTE(G)RLS to improve screening protocols and capture these commonly associated conditions.
Key takeaways
- 77% of ARM patients have cardiac anomalies—highest association rate, making echocardiography essential in newborn screening protocols.
- 25% of female ARM patients have gynecologic malformations; many missed at birth, requiring dedicated pelvic imaging in newborn workup.
- Spinal cord malformations increase from 35% at birth to 45% later—MRI spine should be standard, not deferred, in ARM evaluation.
- Proposed VACTE(G)RLS acronym adds Gynecologic and Spinal cord emphasis to traditional VACTERL screening for comprehensive care.
- Vesicoureteral reflux diagnosed 14% more often after discharge—consider voiding cystourethrogram as part of initial renal assessment.
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