title: Better prognosis in newborns with trisomy 13 who received intensive treatments: a retrospective study of 16 patients.
abstract: Intensive treatment for newborns with trisomy 13 is controversial because of their lethal prognosis. We report the better life prognosis of patients with trisomy 13 who received intensive treatment. At our hospital, we provided an intensive management to such patients including resuscitation and surgical procedures as required. Herein, we present the results of a retrospective study (1989-2010) of 16 trisomy 13 cases who received an intensive treatment. None was diagnosed to have trisomy 13 before birth; 9 were delivered by C-section and oxygen was administered to all patients during postpartum resuscitation. Mechanical ventilation was used in 9 patients after tracheal intubation and tracheotomy was performed in 2 patients when withdrawing of extubation was difficult. Regarding prognosis, 9 patients died, 3 were referred to another hospital, and 4 were discharged from the hospital. Four and 7 patients died within 7 and 30 days after birth, respectively. Nine patients survived for >1 month, 7 for >180 days, and 5 for >3 years. Median survival for 16 patients was 733 days. The patients who received intensive treatments survived longer compared to the previous data. This study provides useful information concerning genetic counseling, especially from an ethical point of view, before providing intensive management to newborns with trisomy 13.
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Kitakobayashi 880, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tsukada
authors.forename: George
authors.initials: G
authors.lastname: Imataka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suzumura
authors.forename: Osamu
authors.initials: O
authors.lastname: Arisaka
mesh_terms: D000328:Adult; D002423:Cause of Death; D025063:Chromosome Disorders / Q000235:genetics* / Q000401:mortality; D002882:Chromosomes, Human, Pair 13 / Q000235:genetics; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014314:Trisomy / Q000235:genetics*; D000073839:Trisomy 13 Syndrome; D055815:Young Adult