Indian Pediatrics - Editorial

Images in Clinical Practice

Indian Pediatrics 2001; 38: 98

Caudal Regression Syndrome

A full term male newborn was delivered vaginally with lower limb deformities. The mother was a non-diabetic primigravida. The deformities were in the form of hyperextension of the lower limbs (Fig. 1), club foot, hypoplastic femur and tibia (Fig. 2). The baby had motor and sensory neurological deficit in the form of lower motor neuron paraplegia and absent anal reflex. There was no imperforate anus but it was malposed. There were two sinuses on either sides of the buttocks. There was no other neural tube defect or renal abnormalities on sonography.

Caudal regression syndrome, also known as caudal dysplasia or sacral agenesis syndrome is a congenital malformation characterized by various degrees of developmental failure involving legs, lumbar, sacral and coccygeal vertebra, and corresponding segments of spinal cord due to defect in neuralisation. This results in motor and sensory deficits. Other congenital anomalies such as gastrointestinal, genito-urinary or congenital heart disease may be present. A history of maternal diabetes is obtained in 16% of such infants.

Archna B. Patel,
Ramesh L. Renge,
Department of Pediatrics and
Clinical Epidemiology Unit,
Indira Gandhi Medical College,
Nagpur, MS, India.

Fig.1. Newborn showing hyperextension of lower limbs. Fig.2. X-ray showing hypoplastic femur, tibia and absent sacrum.