Screening for latent malformations: cost effectiveness in neonates with correctable anomalies.

A screening program for latent malformations in infants born with surgically correctable anomalies was reviewed to determine its cost effectiveness. Two hundred and seventy six infants with esophageal atresia, imperforate anus, omphalocele, gastroschisis, or diaphragmatic hernia were screened for latent congenital anomalies not detected by the routine history, physical examination, and roentgenograms. While additional malformations were detected, many congenital defects were missed only to become evident later in the infant's course. Routine screening for latent malformations is not cost effective in all infants with surgically correctable anomalies, but directed screening is indicated in selected neonates. Screening IVP's are indicated in patients with esophageal atresia, high pouch imperforate anus and possibly diaphragmatic hernia. Screening IVP's are not indicated in infants with gastroschisis, omphalocele, or females with low pouch imperforate anus who have normal sacral spine films.