Prenatal HistoryThis was of great interest. Obstetric features

of note occurred early in pregnancyin nine patients, and late in gestation or atdelivery in nine others. Histories of somemishap occurring in the first or early secondtrimester were : paternal influenza and maternalcoryza in first trimester; spinal anesthesiaat fourth month; maternal viral infectionin third month; bleeding in thirdmonth; maternal respiratory infection earlyin pregnancy; mild spotting in early pregnancy;vaginal bleeding at 6 weeks gestation;

coryza early in second trimester; much“morning sickness” in fourth and fifthmonths.A history of previous miscarriages andspontaneous abortions was not infrequentin mothers of these offspring. An interestingfinding noted in eight instances was advancedage of the mother. In these eightcases, the mother averaged 36 years of ageat time of delivery.Family HistorySeveral interesting findings were noted inthe family histories. The most striking instancewas that of two brothers, 7 and 4years of age, both with the Pierre Robinsyndrome. Their mother stated that thissyndrome had been present in her familyfor four generations, and that each personinvolved had defects of the eyes and ears!These two cases were reported5 elsewherein detail. In one other case, a 4-year-oldsibling, had a cleft palate. There was a historyof parental syphilis in three cases; oneinstance each of parental consanguinity;positive family history for congenital glaucomain a cousin and mongolism in a sibling;and death of a sibling from suffocationat the age of 3 weeks.Birth WeightThe average birth weight in the 39 casesin this series was 2,816 grams. In 14 instancesthe birth weight was less than 2,500grams, and averaged 2,122 grams in these14 children.Age at First Admission andChief ComplaintThree characteristic complaints stood outin the histories of these patients, which accountedfor the age at admission to the hospital.First, choking spells, recurrent boutsof cyanosis and difficulty in swallowingwere almost invariably noted within a veryfew days of birth, and necessitated hospitalizationin the first week of life. Those admittedto the hospital at a later age (severalmonths to 2 years) had recurrent respiratoryinfections, usually attributed to aspiration,or failure to thrive, which at times requiredgavage feedings for months. A third groupwas admitted for surgical repair of cleftpalate, a procedure that was usually deferreduntil after 2 years of age. Other chiefcomplaints were usually concerned with associatedanomalies, to be discussed later.Ocular HistoryIn 26 of the 39 cases, no history of ocular