Treatment and management of trisomy 18 in a neonatal intensive care unit

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  • Toya Yukiko
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Matsumoto Atsushi
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Yoshida Taro
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Ito Ai
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Tsuchiya Shigekuni
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Takashimizu Nao
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Konishi Yu
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Sotodate Genichiro
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
  • Oyama Kotaro
    Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan

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Other Title
  • 新生児集中治療室における18トリソミーへの対応
  • シンセイジ シュウチュウ チリョウシツ ニ オケル 18 トリソミー エ ノ タイオウ

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Abstract

Perinatal history, treatment and management strategy, and prognosis of 15 children with trisomy 18 in a neonatal intensive care unit over the past 10 years were examined. In 15 patients, the possibility of trisomy 18 had been pointed out before birth. The median gestational week was 39.1 weeks and the median birth weight was 1,887g. All patients had complications of congenital heart disease, and three patients underwent surgical treatment for congenital gastrointestinal disease. Only one patient was able to be discharged and 11 patients died in the neonatal intensive care unit. The use of noninvasive or invasive positive pressure ventilation and blood transfusion were related to prolonged survival. Trisomy 18 is accompanied by variegated heart and digestive complications, central apneic attacks, and severe psychomotor development delay, and the 1-year survival rate is reported to be around 10%. But it has been shown that some children have prolonged survival after active treatment intervention. Since the predicted prognosis of the child and the choice of possible treatments are different between patients due to the various severities of complications, it is necessary to respond to each individual case.

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