Edward’s syndrome

Alternative Names:Trisomy 18 (T18), Trisomy E or Edwards syndrome

Definition:
Edward’s syndrome is a genetic disorder caused by the presence of all or part of an extra 18th chromosome. It is named after John H. Edwards, who first described the syndrome in 1960. It is the second most common autosomal trisomy, after Down Syndrome, that carries to term.

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A rare genetic chromosomal syndrome where the child has an extra third copy of chromosome 18.
Trisomy 18 is caused by the presence of three – as opposed to two – copies of chromosome 18 in a fetus or infant‘s cells. The incidence of the syndrome is estimated as one in 3,000 live births. The incidence increases as the mother’s age increases.  Edwards syndrome is more severe than the more common Down syndrome. Edwards syndrome causes mental retardation and numerous physical defects that often cause an early infant death.The syndrome has a very low rate of survival, resulting from heart abnormalities, kidney malformations, and other internal organ disorders. Most fetuses are aborted before term, but a live birth with this condition occurs with a frequency around 1-in-3000.

Edwards’ syndrome occurs in around one in 6,000 live births and around 80 per cent of those affected are female. However, the majority of babies with the syndrome die before birth.

It affects people from all cultural backgrounds and becomes more likely with increasing maternal age.

Symptoms:
The features and problems that develop in children with Edwards’ syndrome vary from child to child.

Typically, a child will have a small head with characteristic facial features including a small jaw and mouth, upturned nose, widely spaced small eyes with narrow eyelid folds and drooping of the upper eyelids, and low-set, malformed ears.

The hands may be clenched, with the second and fifth fingers overlapping the other fingers, and the thumbs may be underdeveloped or absent. Webbing of the second and third toes may also occur.

In addition to these features, all systems of the body may be affected. Structural malformations of the heart, kidneys, brain, digestive tract and genitals may be present and cause the child difficulties. For example, children with the syndrome often have trouble feeding and breathing, and experience delay in growth and development. Infections of the lungs and urinary system are also common.

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Diagnosis:
At birth, if physical characteristics suggest the possibility of Edwards’ syndrome, this can be confirmed with genetic testing.

An ultrasound during pregnancy can often identify foetal abnormalities, providing the opportunity for genetic testing by amniocentesis.

Treatment:
There’s no cure for Edwards’ syndrome, but medical treatment of symptoms is provided as required.

Treatment focuses on providing good nutrition, tackling infections – which arise frequently – and helping the heart to function better.

Many babies with Edwards’ syndrome have difficulties with feeding, so food may be given via a nasogastric tube or directly into the stomach through a gastrostomy. Where limb abnormalities affect movement, physiotherapy and occupational therapy can help.

Emotional support for parents and other members of the family is vital, as babies with Edwards’ syndrome have a shortened life expectancy. Few survive beyond their first year.

Prognosis:
In England and Wales, there were 495 diagnoses of Edwards’ syndrome (trisomy 18) in 2008/2009, of which 92% were made prenatally. There were 339 terminations, 49 stillbirths/miscarriages/fetal deaths, 72 unknown outcomes, and 35 live births. Because approximately 3% of cases of Edwards’ syndrome with unknown outcomes are likely to result in a live birth, the total number of live births is estimated to be 37 (2008/09 data are provisional). Only 50% of liveborn infants live to 2 months, and only 5–10% survive their first year of life. Major causes of death include apnea and heart abnormalities. It is impossible to predict the exact prognosis of a child with Edwards syndrome during pregnancy or the neonatal period. The median lifespan is 5–15 days. One percent of children born with this syndrome live to age 10, typically in less severe cases of the mosaic Edwards syndrome. The small percentage of babies with the full Edwards syndrome who survive birth and early infancy may live to adulthood, and children with mosaic or partial forms of this trisomy may have a completely different and much more hopeful prognosis.

 

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.ispub.com/journal/the_internet_journal_of_third_world_medicine/volume_4_number_1_53/article/edwards_syndrome_in_a_neonate_from_a_developing_country_reasons_for_concern_a_case_report.html
http://www.netdoctor.co.uk/ate/pregnancyandchildbirth/205249.html
http://www.wrongdiagnosis.com/e/edwards_syndrome/intro.htm
http://en.wikipedia.org/wiki/Edwards_syndrome
http://www.bbc.co.uk/health/physical_health/conditions/edwardssyndrome2.shtml

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