“…It has been suggested [8,19] that a general fusion abnormality may explain the simultaneous occurrence of multiple fusion defects such a diaphragmatic hernia, omphalocele, neural tube defect and cleft lip/palate, but this so-called schisis association cannot account for renal or limb defects. Of interest is the similarity between one of the present cases (Table 3, case 14) and cases 932/77 and 365/78 of Czeizel and Metneki [10,11]. In all these cases, two more-or-less distant relatives exhibited various combinations of multiple anomalies consisting of vertebral, renal, limb and diaphragmatic defects (mother and two children; sibs and first cousin; first cousins).…”