The West Midlands Congenital Anomaly Register (CAR) was set up in July 1994 and is administered by the West Midlands Perinatal Institute. The register aims to collect information from conception to the first 2 years of life on the occurrence of suspected and confirmed congenital anomalies. It includes deliveries in any West Midlands maternity unit from residents in any region or deaths from congenital anomalies.

A number of minor anomalies are excluded from the register (see list)

Notifications are received by 2 methods, the first is a notification card usually completed by the Ultrasound department. This notifies the register of suspected anomalies and includes details of the type of anomaly seen on ultrasound and the estimated date of delivery.

The second method is a notification form which contains additional details relating to the date that the anomaly was first suspected and includes the final diagnosis.

The notification forms are completed by midwives, obstetricians and paediatricians. The register is maintained on the same database as otifications of fetal and infant deaths and in this way, the prevalence of fetal anomalies in perinatal deaths can be validated. All anomalies are coded using ICD 10. Addition information is received from cytogenetics labs and departments of public health (form SD56) inpatient activity of infants with anomalies are received from hospital information departments. These extra data are matched to the existing notifications to give estimates of ascertainment and additional clinical information is added in some cases.