Neonatal management of trisomy 18: Clinical details of 24 patients receiving intensive treatment.

Title

Neonatal management of trisomy 18: Clinical details of 24 patients receiving intensive treatment.

Creator

Kosho T; Nakamura T; Kawame H; Baba A; Tamura M; Fukushima Y

Publisher

American Journal Of Medical Genetics.Part A

Date

2006

Subject

Female; Humans; infant; Male; Survival Rate; Pregnancy; Prognosis; Prenatal Diagnosis; Survival Analysis; Longitudinal Studies; Birth Weight; Newborn; cause of death; Chromosomes; gestational age; Human; Pair 18/genetics; Trisomy/diagnosis/genetics; Children W/SNI; Chromosome Disorders/genetics/mortality/therapy; Fetal Diseases/diagnosis/genetics

Description

Management of neonates with trisomy 18 is controversial, supposedly due to the prognosis and the lack of precise clinical information concerning efficacy of treatment. To delineate the natural history of trisomy 18 managed under intensive treatment, we reviewed detailed clinical data of 24 patients with full trisomy 18 admitted to the neonatal intensive care unit of Nagano Children's Hospital, providing intensive treatment to those with trisomy 18, from 1994 to 2003. Cesarean, resuscitation by intubation, and surgical operations were performed on 16 (67%), 15 (63%), and 10 (42%) of the patients, respectively. Mechanical ventilation was required by 21 (88%), and 6 (29%) of them were extubated. Survival rate at age 1 week, 1 month, and 1 year was 88%, 83%, and 25%, respectively. Median survival time was 152.5 days. Respiration was not stabilized in two patients with left diaphragmatic eventration and hypoplasia accompanied by lung hypoplasia, even with maximal ventilation. The common underlying factors associated with death were congenital heart defects and heart failure (96%), followed by pulmonary hypertension (78%). The common final modes of death were sudden cardiac or cardiopulmonary arrest (26%) and possible progressive pulmonary hypertension-related events (26%). These data of improved survival, through neonatal intensive treatment, are helpful for clinicians to offer the best information on treatment options to families of patients with trisomy 18.
2006

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

937-944

Issue

9

Volume

140

Citation

Kosho T; Nakamura T; Kawame H; Baba A; Tamura M; Fukushima Y, “Neonatal management of trisomy 18: Clinical details of 24 patients receiving intensive treatment.,” Pediatric Palliative Care Library, accessed May 19, 2022, https://pedpalascnetlibrary.omeka.net/items/show/13806.

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