Prenatal History

This was of great interest. Obstetric features

of note occurred early in pregnancy
in nine patients, and late in gestation or at
delivery in nine others. Histories of some
mishap occurring in the first or early second
trimester were : paternal influenza and maternal
coryza in first trimester; spinal anesthesia
at fourth month; maternal viral infection
in third month; bleeding in third
month; maternal respiratory infection early
in pregnancy; mild spotting in early pregnancy;
vaginal bleeding at 6 weeks gestation;
coryza early in second trimester; much
morning sickness in fourth and fifth
months.
A history of previous miscarriages and
spontaneous abortions was not infrequent
in mothers of these offspring. An interesting
finding noted in eight instances was advanced
age of the mother. In these eight
cases, the mother averaged 36 years of age
at time of delivery.
Family History
Several interesting findings were noted in
the family histories. The most striking instance
was that of two brothers, 7 and 4
years of age, both with the Pierre Robin
syndrome. Their mother stated that this
syndrome had been present in her family

for four generations, and that each person

involved had defects of the eyes and ears!
These two cases were reported5 elsewhere
in detail. In one other case, a 4-year-old
sibling, had a cleft palate. There was a history
of parental syphilis in three cases; one
instance each of parental consanguinity;
positive family history for congenital glaucoma
in a cousin and mongolism in a sibling;
and death of a sibling from suffocation
at the age of 3 weeks.
Birth Weight
The average birth weight in the 39 cases
in this series was 2,816 grams. In 14 instances
the birth weight was less than 2,500
grams, and averaged 2,122 grams in these
14 children.

Age at First Admission and

Chief Complaint
Three characteristic complaints stood out
in the histories of these patients, which accounted
for the age at admission to the hospital.
First, choking spells, recurrent bouts
of cyanosis and difficulty in swallowing
were almost invariably noted within a very
few days of birth, and necessitated hospitalization
in the first week of life. Those admitted
to the hospital at a later age (several
months to 2 years) had recurrent respiratory
infections, usually attributed to aspiration,
or failure to thrive, which at times required
gavage feedings for months. A third group
was admitted for surgical repair of cleft
palate, a procedure that was usually deferred
until after 2 years of age. Other chief
complaints were usually concerned with associated
anomalies, to be discussed later.

Ocular History
In 26 of the 39 cases, no history of ocular