Topic: Medical Complications Copy
?Decision Point: What are the chances of other health issues for our child?
a) “There are a variety of medical issues that usually surface with these children. There are often heart problems, digestive problems, muscle tone problems, and hearing and vision difficulties, among others. It is not a good picture.”
Incorrect. This response presents only the potential negative aspects of Down syndrome and suggests that most children with Down syndrome will have many, if not all, of these problems.
b) “Heart defects are the big issue, but we really can’t do anything about that before these babies are born, anyway. If you decide to go through with this pregnancy, we will check with a pediatric cardiologist immediately after birth to diagnosis and deal with potential heart defects.”
Incorrect. Pediatric cardiologists are often involved prenatally since heart defects may be detected before birth. Because of the high incidence of heart defects for children with Down syndrome, physicians often notify these specialists to be available during delivery.
c) “The most likely complications are heart problems that occur in about 50% of these children. I can refer you immediately to someone, who can do a high resolution ultrasound or fetal echo to check for that with your baby. If the baby does have a heart defect, many of these conditions are correctable at an early age, most often in infancy.”
Correct. The doctor gives accurate information about the most frequently related medical condition without overwhelming the parents. He also gives encouragement about possible treatment for the future.
Video Transcript
Dr. Thomas: The most serious complications are heart problems that occur in about 50% of these children. I can refer you immediately to someone, who can do a high resolution ultrasound or fetal echo to check for that with your baby. If the baby does have a heart defect, many of these conditions are correctable at an early age, most often in infancy. The information from the fetal echo can also be used to prepare you and the baby for delivery.
Mrs. Abbott: If we do decide to carry this baby, doctor, what will the rest of my pregnancy look like? Will I have to stay in bed or take special precautions? How about delivering this baby? Will it be any different?
While there are a variety of medical conditions possible with Down syndrome, the doctor focuses only on heart defects, since these conditions are the more frequently encountered. He also provides the most up-to-date information on treatment for these conditions.
?Decision Point: What would you say next?
a) “We will want to monitor his health carefully, especially if he does have a heart defect. I anticipate that your pregnancy will otherwise be normal, but in all likelihood, we will have to do a C-section, because of the stress of birth on these children.”
Incorrect. C-sections are not done automatically, even in the presence of a heart defect.
b) “We will want to monitor his health carefully, especially if he does have a heart defect. I anticipate that you will have to stay off your feet as much as possible during this pregnancy, and in all likelihood, we will have to do a C-section, because of the stress of birth on these children.”
Incorrect. The mother’s inactivity will not help a baby in utero with a heart defect. While C-sections are common, they are not always a necessary part of delivering a baby with Down syndrome and a heart defect.
c) “We will want to monitor your baby’s health carefully, especially if the baby does have a heart defect. However, I anticipate that your pregnancy will otherwise be normal, as well as your delivery.”
Correct. The doctor assures the mother that he will carefully follow-up on potential conditions. At the same time, most pregnancies of this type are more like others than they are different.