The initials in V.A.T.E.R. syndrome refer to five different areas in which a child may have abnormalities: Vertebrae, Anus, Trachea, Esophagus, and Renal (kidneys). There may also be cardiac and limb conditions, which changes the acronym to V.A.C.T.E.R.L. A child diagnosed with one of these syndromes will not necessarily have a problem in every area, but a constellation of birth defects involving many of the areas. There is no currently known cause, but a gene defect is believed to be involved.