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Congenital anomalies
Congenital anomalies are even more important than we might think, not just in terms of their obvious morbidity, but in relation to their contribution to avoidable deaths across the world. Boyle et al have demonstrated that the WHO massively underestimates the impact of congenital anomalies in relation to the global burden of disease, mostly by excluding malformed stillbirths and terminations for fetal anomaly. Little progress has been made in Europe with regard to primary prevention of congenital anomalies; in particular the absence of universal folate supplementation represents a tragic failure of public health policy to which specific attention was drawn recently in these pages (Arch Dis Child 2016;101:604–7). See page F22 .
Does MRI help?
The act of doing an investigation comes with potential unintended consequences and even harms, so it was important to ask the question of the effect of MRI brain scans in preterm babies who have reached around 40 weeks postmenstrual age. Edwards et al compared MRI with ultrasound imaging: all babies were imaged but there was randomisation between sharing with parents the knowledge of MRI or ultrasound results. As expected, neither modality was sufficiently specific on an …
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