Neonatal screening of developmental dysplastic of hip (DDH) in breech delivered
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Date
2007
Authors
Yusoff, Zakaria
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
Introduction: Developmental dysplasia of the hip (DDH) is a disorder that represents
abnormal development or dislocation of the hip secondary to capsular laxity and
mechanical factor. It was reported that incidence of DDH in life born babies was very
low in Malaysia. However there is no reported study on breech babies in Malaysia.
Neonatal screening using Ortolani and Barlow is known to have poor sensitivity which
will become better with the experience of examiner. In the current practice, this test is
done by medical officer as part of other neonatal screen. We conducted this study to
detennine the incidence of DDH in breech babies using Ortolani and Barlow test. We
also compared the fmding of examination result between dedicated examiner and routine
examiner.
Method: This was a cross-sectional study, conducted from October 2005 to December
2006 at Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan and at Hospital
Universiti Sains Malaysia. In the period of the study, 180 babies were examined by
dedicated examiner and it is equivalent to 66.9 %of breech deliveries in both hospitals.
Out of this, 30 babies were selected to be examined by routine examiner and dedicated
examiner which later confirm with ultrasound examinations as the gold standard. The
selection was made based on parents consent for ultrasound examination.
Result: Out of 180 breech babies, six babies (3.3 %) had positive Ortolani and Barlow
test. All 6 babies were among 127 babies delivered through Lower Segment Caesarean
Section. Four out of six babies were female and two are male. From 30 selected samples,
dedicated examiner detected five babies with positive Ortolani and Barlow test. However
routine examiner did not detect any positive Ortolani and Barlow test. Based on
ultrasound as gold standard, the dedicated examiner has sensitivity of 0.67 and specificity
of0.97.
Conclusion: High incidence (3.3%) of positive Ortolani and Barlow test among breech
babies supports the need for special attention to this population of patients. A dedicated
hip screener for neonatal examination has the ability to detect DDH better than the
routine examiner.
Description
Keywords
Developmental dysplasia