Trisomy 18 and 13 | Symptoms & Causes
What causes trisomy 18 and trisomy 13?
Trisomy 18 and 13 are usually caused by spontaneous genetic mutations that occur at the time of fertilization. Normally, each egg and sperm cell contains 23 chromosomes. The union of these cells creates 23 pairs, or 46 total chromosomes, half from the mother and half from the father. Sometimes, an error occurs when an egg or sperm cell is forming, causing it to have an extra chromosome #18 or #13.
- When this cell contributes the extra chromosome 18 to the embryo, trisomy 18 results.
- When this cell contributes the extra chromosome 13 to the embryo, trisomy 13 results.
The extra chromosome 18 or 13 can come from either the mother's egg cell or the father's sperm cell.
In some instances, the extra chromosome 18 or 13 is attached to another chromosome in the egg or sperm. This is called translocation and is the only form of trisomy 18 or 13 that can be inherited. Sometimes, a parent can carry a "balanced" rearrangement in which chromosome 18 or 13 is attached to another chromosome. However, since the parent does not have any extra or missing chromosome material, they are said to have a "balanced translocation" and they are usually normal and healthy.
Meet Brooklyn
Brooklyn is a happy toddler who loves playing on her toy piano and discovering new things. She has also overcome hurdles related to the chromosomal condition trisomy 18, and for that, her parents appreciate the treatment she receives through Boston Children’s Cardiovascular Genetics Center.
Trisomy 18 and 13 | Diagnosis & Treatments
How we diagnose trisomy 18 and trisomy 13
Chromosomal abnormalities such as trisomy 18 and 13 can be diagnosed before birth by analyzing cells in the amniotic fluid (amniocentesis) or from the placenta.
- A fetal ultrasound during pregnancy can also give information about the possibility of trisomy 18 or 13, but ultrasound is not 100 percent accurate because some babies with trisomy 18 and 13 may look the same on ultrasound as those without the syndrome.
- A chromosome analysis, whether performed on a blood sample, cells from the amniotic fluid, or placenta, is over 99.9 percent accurate.
Since trisomy 18 and trisomy 13 each have a unique group of characteristics, a physician may be able to determine simply by physical examination whether a baby has trisomy 18 or 13. To confirm the physical findings, a small blood sample can be taken and the chromosomes can be analyzed to determine the presence of an extra 18 or 13 chromosome.
There is no cure for trisomies 18 and 13 at this time. Treatment is based on support and managing symptoms. In fact, many babies born with these disorders may not live beyond the first few days or weeks of life. It is important to discuss whether to use life support measures or other medical procedures.
Trisomy 18 and 13 at Boston Children's Hospital
Decisions surrounding the care of infants with trisomy 18 and 13 are difficult and personal. Your doctors at Boston Children's can connect you with resources available to provide support and help your during this time, including early intervention services, social workers, the Department of Spiritual Care (chaplaincy), and genetic counselors.
Other families who have or have had a baby with trisomy 18 or trisomy 13 are particularly helpful and supportive, since they have experienced many of the same questions and emotions. We can help connect you to families who have faced similar situations.
