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Home / IAS Preparation / Edwards Syndrome (Trisomy 18)

Edwards Syndrome (Trisomy 18): Causes, Symptoms, and Treatment

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Edwards syndrome, also known as Trisomy 18, is a chromosomal disorder caused by the presence of an extra copy of chromosome 18. It is named after Dr. John H. Edwards, who first described the condition in 1960. Edwards syndrome is a rare congenital disorder that affects approximately 1 in every 5,000 live births. Although the syndrome is associated with a high mortality rate, advancements in medical care have increased the life expectancy and quality of life for affected individuals.

This topic is important from the perspective of the UPSC IAS Examination which falls under General Studies Paper 3 (Mains) and General Studies Paper 1 (Preliminary) and particularly in the Science & Technology section of the UPSC Exam. 

 In this article, we will explore the various aspects of Edwards syndrome, including its causes, symptoms, and available treatments.

What is Edwards Syndrome (Trisomy 18)?

Edwards syndrome is a genetic condition caused by the presence of an extra copy of chromosome 18. Normally, individuals have two copies of each chromosome, but in the case of Edwards syndrome, there is an additional copy of chromosome 18. This extra genetic material disrupts normal development, leading to a wide range of physical and intellectual disabilities.

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Types of Trisomy 18

Trisomy 18 can occur in three different forms, each with varying levels of severity:

  • Full Trisomy 18: This is the most common form of Edwards syndrome, where every cell in the body contains three copies of chromosome 18.
  • Mosaic Trisomy 18: In this form, some cells have the extra chromosome 18, while others have the normal pair. Mosaic Trisomy 18 often leads to milder symptoms compared to full Trisomy 18.
  • Partial Trisomy 18: This occurs when only a portion of chromosome 18 is duplicated instead of the entire chromosome. Partial Trisomy 18 is the least common form and often results from specific genetic abnormalities.

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Edwards Syndrome Symptoms

Edwards syndrome is characterized by a wide range of physical and developmental abnormalities. The symptoms and their severity can vary from person to person, but some common features include:

  • Low birth weight and slow growth
  • Small head (microcephaly) and a prominent back part of the head (occipital prominence)
  • Facial abnormalities, such as a small jaw (micrognathia), small mouth, and low-set ears
  • Clenched fists with overlapping fingers and underdeveloped thumbs
  • Congenital heart defects, such as ventricular septal defects (VSD) or atrial septal defects (ASD)
  • Kidney malformations or urinary tract abnormalities
  • Severe intellectual disability and developmental delays
  • Digestive issues, including feeding difficulties and gastroesophageal reflux
  • Skeletal abnormalities, such as clubfoot or webbed toes
  • Breathing problems and episodes of apnea (temporary cessation of breathing)

Edwards Syndrome Causes

The vast majority of Edwards syndrome cases, approximately 95%, are caused by a spontaneous error that occurs during the formation of the reproductive cells (sperm or egg) or early embryo development. The exact cause of this chromosomal abnormality is still unknown. However, advanced maternal age is considered a significant risk factor, as older women have an increased likelihood of producing eggs with chromosome errors.

Less commonly, Edwards syndrome can be inherited from a parent who carries a rearrangement of chromosome 18 or a translocation involving chromosome 18. In such cases, there is an increased risk of having a child with Trisomy 18.

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Treatment for Edwards Syndrome

There is no cure for Edwards syndrome, and treatment focuses on managing the individual symptoms and providing supportive care. A multidisciplinary approach involving healthcare professionals from various specialties is crucial to ensure the best possible outcomes. Some of the common interventions and treatments for Edwards syndrome include:

  • Surgical correction of congenital heart defects
  • Physical, occupational, and speech therapy to support developmental milestones and improve motor skills
  • Nutritional interventions, including dietary supplements, to promote growth and address feeding difficulties
  • Regular monitoring of organ systems to detect and manage complications promptly
  • Palliative care to enhance comfort and quality of life

Nutritional Guidelines for Edwards Syndrome

Proper nutrition plays a vital role in supporting the growth and development of individuals with Edwards syndrome. Here are some essential considerations to keep in mind:

Feeding difficulties: Many infants with Edwards syndrome have trouble feeding due to low muscle tone (hypotonia) and coordination issues. It may be necessary to consult a speech therapist or occupational therapist specializing in feeding difficulties to ensure adequate nutrition.

Calorie intake: Because individuals with Edwards syndrome often have low birth weight and experience slow growth, it's important to provide sufficient calories to support their nutritional needs. A healthcare professional can guide parents on appropriate calorie intake based on the child's specific requirements.

Nutritional supplements: In some cases, dietary supplements may be recommended to address specific nutritional deficiencies or needs. These can include vitamins, minerals, or other essential nutrients.

Feeding techniques: In addition to the nutritional aspect, optimizing feeding techniques, such as using appropriate feeding positions or specialized equipment, can aid in improving feeding efficiency and reducing related complications.

Conclusion: Relevance to UPSC Aspirants

For UPSC aspirants, having a comprehensive understanding of medical conditions like Edwards syndrome is essential. The civil services examinations cover a broad range of topics, including health and genetics. Familiarity with Edwards syndrome and other genetic disorders enhances the aspirants' knowledge base and ensures they are well-prepared to tackle questions related to medical science and associated social issues.

By delving into the causes, symptoms, and available treatments for Edwards syndrome, aspirants can gain an appreciation for the challenges faced by individuals with genetic disorders and their families. This knowledge contributes to holistic preparation, enabling aspirants to approach topics from multiple perspectives and develop well-rounded answers.

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Edwards Syndrome FAQs

Yes, Edwards syndrome can be detected through prenatal screening tests, such as non-invasive prenatal testing (NIPT) or amniocentesis. These tests analyze fetal DNA or cells from the amniotic fluid to identify chromosomal abnormalities.

The life expectancy of individuals with Edwards syndrome varies widely depending on the severity of their symptoms and the presence of associated complications. While some affected individuals survive beyond infancy, many unfortunately pass away during the first year of life.

The majority of Edwards syndrome cases are not inherited and occur due to spontaneous chromosomal errors. However, in rare cases, Edwards syndrome can be inherited if a parent carries a rearrangement or translocation involving chromosome 18.

Currently, there are no proven preventive measures to avoid the occurrence of Edwards syndrome. However, certain prenatal screening tests can provide information about the risk of having a child with chromosomal abnormalities, allowing parents to make informed choices about their pregnancy.

Yes, the vast majority of individuals with Edwards syndrome experience severe intellectual disability. However, the level of intellectual functioning can vary among affected individuals. It's important to provide appropriate educational and developmental support to maximize their potential for learning and growth.
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