Multiple congenital anomalies. An approach to management.

The multiplicity of problems associated with spina bifida and CHARGE syndrome illustrate a management approach for any child with multiple congenital anomalies. Specific etiology should be established whenever possible to accurately predict prognosis, complications, and recurrence risks. A systematic evaluation of individual medical, psychosocial, and developmental issues is necessary to rank priorities within these areas. A management team of specialists to deal with these priorities can then be assembled, and good communication among team members is essential.