ABSTRACT
Many congenital defects that are of interest to the pediatric surgeon can now be detected before birth; thus, the preoperative assessment of the newborn with a possible congenital anomaly starts in utero. Neonates born with congenital malformations are usually in urgent need of surgery and, in addition to their surgical problem, may suffer from a multitude of medical problems. All neonates undergoing surgery must be carefully assessed preoperatively, giving particular attention to the following: history and physical examination; maintenance of body temperature; respiratory function; cardiovascular status; metabolic status; coagulation abnormalities; laboratory investigations; vascular access; and fluid and electrolytes, and metabolic responses. Maintenance fluid requirement consists of water and electrolytes that are normally lost through insensible loss, sweat, urine, and stools. Premature infants between 34 and 37 weeks' gestational age undergo rapid maturation of renal function similar to term infants with rapid establishment of glomerulotubular balance early in the postnatal period.
