Down Syndrome essay

Down syndrome (usually abbreviated DS) is a medical condition caused by a chromosomal disorder in which the patient has 47 chromosomes instead of the normal 46. People suffering from Down syndrome are characterized by mental retardation (with a mean IQ score of less than 50), dysmorphic facial characteristics, and many other phenotypic features. It is believed that the condition is the most popular genetic cause of mental and intellectual retardation and disability. This paper will analyse the cause, diagnosis, symptoms and the risk factors associated with this condition. It will give a case study, in terms of research, which shows the importance of not having children very late in life, as this may increase the risk of Down syndrome in the children.

Cause

Down syndrome is mostly caused by the abnormal nature of the patient having three distinct copies of chromosome 21(usually called trisomy 21) in each cell of the body. On a few occasions though, Down syndrome may be caused when there is an additional chromosome in some of the body cells, usually referred to as mosaic trisomy 21. In some cases, there may be either an additional copy or portion of chromosome 21 that is attached onto another different chromosome (this is called translocation trisomy 21). Down syndrome affects all organs in the body which lead to organ system malfunctioning and impairments, both cognitive and physical (Pinto & Schub 2011).

Effects

Down syndrome affects the organ system of the body leading to defects such as hearing and visual impairment, celiac disease, congenital heart disease, and autism. It can also lead to the onset of the Alzheimer’s disease (Pinto & Schub 2011).

Diagnosis

Down syndrome can end up being diagnosed at the prenatal stage. Diagnosis can end up being done using several techniques, such as chorionic villus sampling, amniocentesis, as good as sampling the percutaneous umbilical blood. These tests can be invasive within nature though. Additionally, a specialized risk assessment could be conducted to analyse the danger levels and determine when further testing should end up being done. Finally, the condition might be diagnosed during birth if it had not necessarily been detected prenatally. The particular diagnosis at this stage is performed via the aid of cytogenetic studies (Pinto & Schub 2011).

Symptoms

Persons together with Down syndrome show varying signs accompanied by diverse medical conditions. Some associated with the more common actual physical characteristics of an All the way down syndrome patient are a new flat face and nose bridge, uncharacteristically short neck of the guitar, slanted eyes that have got epicanthal folds, almost no curly hair (on the head) in addition to eyelashes, very small ear, a crease in the palm (hand), whitish places on the iris, brachycephaly, and a protruding tongue. A few male patients may have got undescended testicles. Infants along with the condition may suffer from hypotonicity as okay as a seizure disorder (Pinto & Schub 2011).

Down syndrome can also be manifested in persons by means of hearing and visual impairments, a never-ending constipation, inborn heart disease, hypothyroidism, plus endocarditis. Other medical circumstances associated with Down problem are atlantoaxial instability which often can lead to neurological disorders, celiac disease, stenosis, URI’ s, atopic hautentzündung, insomnia, and obesity. Older people with this condition tend in order to show indications of aging in an unusually early age. These signs include lack of tresses (early greying), wrinkling of the skin and neoplasms. Young adults and adolescents could also suffer from vision vascular disease. Infant individuals take a longer moment to develop their speech and language skills (Pinto & Schub 2011).

Treatment

Persons hurting from Down syndrome might exhibit differing levels regarding disabilities. In most situations, the patients are permitted to live with their own family members where these people have the very best chance associated with developing their social health. On the other hands, some of them might require a specialized habitat exactly where they will be less than intense supervision while becoming put through some kind of personalized routine tasks. This kind of patients is said to have got higher levels of the disease and thus demand more help by professionals. The treatment of the particular patients will also be guided by simply the level of impairment. However the treatment is rather complex due in order to the many organs that are affected. Therefore, the remedy includes many specialized well being care experts from many fields. These health proper care experts include cardiologists, orthopaedics, neurologists, and ophthalmologists. Counselors dealing with physical and mental well-being, speech plus language development and nourishment may be involved since well (Pinto & Schub 2011).

Risk Element

It has been proven that the probability of a child being given birth to with Down syndrome raises as the maternal age likewise increases. This simply indicates that a mother who else gives birth at forty years has a higher possibility of getting a youngster with the condition than a mother of more than 20 years. For instance, mothers regarding 35 years have a danger of 1: 385 regarding giving birth to the child using the condition. This specific risk increases to a good incredible 1: 106 with regard to 40-year-old mothers. The risk is even more for mothers at 45 years of age, at 1: 30. This particular simply suggests that home owners mothers must not wait until it is too late to possess a child, as typically the children will be at a good elevated risk of getting Down syndrome (Pinto & Schub 2011).

Case Study

Most couples are usually happy when their youngster is conceived. They usually are always expectant of getting a healthy baby would you later turn out to be able to be a great individual. The anxiety that occurs with the conceiving and birth of a child is always intense. While expecting typically the best for the expected child is great indeed, the chance of getting a very healthy baby is not so assured. This is why couples are always advised to go to the antenatal treatment centers at different stages associated with the pregnancy to ensure that the foetus is expanding as expected. It is usually during these visits of which any anomalies can get detected and, if achievable, rectified. Because the paper has already mentioned, Down symptoms can be diagnosed in a child prenatally or at birth. However, it is a good idea that the mother moves for the tests really early during the being pregnant. This would make diagnosis easier. Thus, couples should always plan to pay a visit to typically the prenatal clinicians in order that the graine is tested for Down syndrome. This should be done early in the maternity, most preferably in the first trimester.

Straight down syndrome may be the commonest result in of chromosome disarrangement in the human body. However, a subcutaneous pile upward of fluid just behind the neck some 9 to thirteen weeks directly into the pregnancy (+ 6) can be visualized plus scanned by ultrasound to be nuchal translucency. The increase in nuchal translucency within the foetus signifies the particular increase in the probability of the foetus developing chromosomal anomalies, as well as other foetal disorders in addition to genetic syndromes. This just suggests that the increase inside the nuchal translucency may signify the development of Down syndrome. These area discusses a case study, in terms of a new research, that was carried out to prove why getting children at an older age increases the chance of the baby having the particular condition.

Aim of the Research

This research was primarily aimed at evaluating the nuchal translucency screening for Down syndrome in the foetus (at 11 -13 weeks (+ 6 days)) of the pregnancy in relation to the maternal age. The research was conducted and written by Disdarevic et al., in 2011.

Methodology

In this research, a total of 105 pregnant women were participating. These women were supposed to be between eleven to thirteen weeks (+ 6 days) into the pregnancy at the time of the research. The research itself was conducted for five months at the University of Sarajevo’s Department of Gynaecology and Obstetrics. The studied mothers had to be strictly within the set gestation period. This had to be confirmed using information from the women’s last menstrual period. To be assured of the credibility of this information, the Crown rump length of the foetuses was measured. At this time, this length should be ranging from about 45 to 84 mm.

Procedure

First and foremost, the foetus is viewed longitudinally (the midline section). This view is then obtained with the corresponding image, magnified in such a way that the foetus will fill all or most of the image. When this has been done, the unborn is measured from the head up to the rump. It should be ascertained the foetus is neutrally positioned. The foetuses were found to be within the rangee of 45 to 84 mm long.

Now that the foetuses are of the prerequisite age, their respective nuchal translucency was thus measured. This was done using five ultrasonographers that conformed to the guideline set up by the Fetal Medicine Foundation. This measurement also strictly followed conventional methodological criteria. The scans were conducted with the help of trans-abdominal ultrasound in the middle section of the sagittal plane. The foetus at this stage is made to cover about three quarters of the image. All the measurements (Callipher) were rounded off to 0.1 mm. To reduce the occurrence of large errors, a lot of care was taken to ensure that both the skin of the foetus and amniotic membrane were clearly visible. The subcutaneous translucency, being the main object of the research, had its thickness measured not once or twice, but for several times. The largest recorded thickness was the measurement used in the analysis. There are some cases that required the use of foetal karyotyping. Such cases included those of women that were more than 35 years of age and whose family history has experienced aneuploidy at some point and the cases where the measured nuchal translucency was more than 3 mm.

Results

The median age of the pregnant women in the study was 33.0 years, the inter quartile range age was 15 years. Out of the 105 women that were studied, 54 of them were 35 years of age or over. This represented 51.4 % of the total. For the women who were 35 years or over, the nuchal translucency recorded more than 2.5 mm in six foetuses; 2.6 mm in four of them and 3.6, 4.5 mm in the other two. The 3.6 mm and 4.5 mm cases were measured in the pregnant women that were 35 and 37 years old, respectively. Additionally, there was one case where the nuchal translucency was measured to be -4.5 mm. This simply meant that this foetus had Down syndrome. There was also one karyotype case that was found to be normal, at nuchal translucency -3.6.

For the pregnant women that were below 35 years old, the nuchal translucency measurement was normal. It was also discovered that there was statistic difference in the frequency of nuchal translucency values of more than 2.5 mm between the two groups of women.

Discussion

Trisomy 21 comes about due to an anomaly in the spermatozoid or the egg cell. It can also come about when there is a genetic error, while the unborn is still at the embryonic stage. The increasing risk of Down syndrome in babies with increasing maternal age can be attributed to the relatively longer latent period of egg cells of the women at the primary follicle level, coupled with the diplogenetic subphase process of the meiosis (usually referred to as I prophase).  This extended period of the egg cell in the latent state may result in disorders in the cell metabolism. As a result, the normal cellular divisions as well as the proper arrangement of the chromosomes would be interfered with. This simply means that haploid formation would be impaired. Lastly, the regular number of chromosomes would not be polyploid (Dizdarevic et al. 2011).

Studies have shown that the increase in nuchal translucency can be used to identify up to 76 % of foetuses having trisomy 21.  Additionally, in the 1,015 foetuses that are currently undergoing karyotyping during the first trimester of the pregnancy due to increasing thickness in the nuchal translucency, it has been proved that the risk of chromosomal disorders increases with maternal age, as well as the nuchal translucency thickness (Nicholaides 2004). Lastly, it has been observed that the incidences of trisomies 21, 18, 13 in the unborns with NT thickness of 3, 4, 5, and more than 6 mm were estimated at 3 times, 18, 28 and 36 times higher than the expected incidences, based on age of the mother (Pandya et al. 1995).

Conclusion

Down syndrome can bring a lot of suffering to the patients and their families. The good thing is that the condition can be detected and diagnosed well in time. This fact underscores the importance of pregnant mothers visiting the clinics regularly, well before the child is born. However, as we have seen, the risk of getting a child with Down syndrome increases with the maternal age. Therefore, it is advisable for couples not to have children after 40. If this is not possible, then they should be constantly in touch with their doctors.

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