Patau syndrome with a long survival: a case report

By: A.C. Duarte, A.I.C. Menezes, E.S. Devens, J.M. Roth, G.L. Garcias and M.G. Martino-Roth
Genetics and Molecular Research 3 (2): 288-292 (2004)
 
ABSTRACT
Trisomy 13 is a clinically severe entity; 85% of the patients do not survive beyond one year, and most children die before completing six months of age. We report a female child, 28 months old, white, the fourth child of a non-consanguineous couple, who presented trisomy 13. The child was born at term, from a vaginal delivery, weighing 2600 g. At birth, she was cyanotic, icteric, spastic, and cried weakly. The initial clinical examination detected polydactyly in the left hand, congenital clubfoot and convex soles, ocular hypertelorism, a low nasal bridge, numerous hemangiomas distributed throughout the body, cardiomegaly, and perimembranous inter-ventricular communication. There was no cleft lip or palate. On physical examination at 18 months old, the child weighed 6,900 g, had a cephalic perimeter of 41 cm, a thoracic perimeter of 43 cm and was 76 cm tall. At 28 months, she weighed 10,760 g and was 88.5 cm tall. Neuropsychomotor development retardation was evident from birth and, according to the psychologist and the social assistant of APAE (Handicapped Parents and Friends Association) in Canguçu, Rio Grande do Sul, there was a noticeable improvement after physiotherapy and recreational sessions.
 

Can rationing possibly be rational?

 
2011 Canadian Medical Association or its licensors
CMAJ 2011. DOI:10.1503/cmaj.109-3932
 
Annie Farlow was just short of three months old when she died in an Ontario hospital of what her parents believe might have been a treatable respiratory condition.
 
Born with the chromosome disorder Trisomy 13, Annie had little chance of surviving to her teens, but her parents, Barbara and Tim Farlow, took comfort in the hospital’s assurance that her disorder wouldn’t preclude her from receiving the same level of care as any other child with a medical condition.
 
But months after Annie’s death, the Farlows discovered that physicians had not initiated emergency resuscitation measures with the same alacrity as in other cases. They also learned that a physician had placed a “do not resuscitate” order on Annie’s chart without their consent. Subsequently, their daughter received an undisclosed quantity of narcotics that, in their opinion, may have caused her “unexplained, rapid” decline.
 
The circumstances surrounding Annie’s death have the Farlows asking questions that plague Canadian patient advocates, health care workers, ethicists and policy-makers faced with a growing scarcity of resources: When is it appropriate to limit or withdraw potentially beneficial treatment? How should decisions be made? Who should make them?
 
“I never took the position that my daughter had a right to any and all treatments, but the unilateral decisions we believe the doctors made should have been made transparently. We have a right to know and appeal the limits of the system and be provided with whatever care is possible within its confines,” Barbara Farlow says. “Not only do I believe my daughter was denied a chance to prolong her life, the secrecy in which decisions seem to have been made also meant she was denied timely palliative care, and she suffered greatly at the end.”
 
You can also see this article at cmaj.ca

Aprenda sobre a trissomia do cromossomo 13 – Síndrome de Patau (Vídeo)

Este vídeo é uma coleção de fotos de crianças com trissomia do cromossomo 13. Assista e aprenda um pouco mais sobre este desarranjo genético.


Visite www.livingwithtrisomy13.org

Crianças sem igual, amor sobrenatural

Não existe uma pegada tão pequena que não deixe sua marca neste mundo. 

A singularidade de cada uma das crianças deste vídeo não as impediu de receber o que existe de mais precioso neste mundo: o amor. 

 

Natural Outcome of Trisomy 13, Trisomy 18, and Triploidy After Prenatal Diagnosis

Introduction
 
Trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome) are, along with trisomy 21 (Down syndrome), the most common autosomal aneuploidies in the newborn, with a prevalence at birth of between one in 3,000 and one in 15,000 [Smith, 1964; Carter et al., 1985; Baty et al., 1994; Hasslod and Hunt, 2001].
Triploidy belongs to the polyploid types, and is estimated to occur in 1–2% of recognized human conceptuses. Most pregnancies with triploidy, however, are aborted spontaneously in early gestation so that the prevalence at birth of triploidy is rare: approximately one in 50,000 newborns [Doshi et al., 1983; McFadden and Kalousek, 1991].
 
All these chromosomal abnormalities belong to disorders which are compatible with life, but which are also associated with a high rate of spontaneous abortion, intrauterine death, and a short life span. [O’Connor, 2008].
 

Over the last 30 years, prenatal diagnosis of these disorders has improved due to the increasing use of fetal ultrasound screening methods in the first and second trimesters, and invasive diagnostic methods such as amniocenteses. In Austria, as in many other countries, parents are given the opportunity to terminate a pregnancy (artificially induced abortion) if a severe fetal disorder has been diagnosed. Only a few parents, therefore, decide to continue with a pregnancy after a prenatal diagnosis of trisomy 13, trisomy 18, or triploidy.

[…]

The aim of this study was to analyze the outcome of continued pregnancies after prenatal chromosomal diagnosis of trisomy 13, trisomy 18, or triploidy. These new data are aimed at improving the consulting process for parents who are confronted with prenatal diagnoses of these chromosomal abnormalities.