Foetal abnormality diagnosis

IF YOU ARE FACING A FETAL ABNORMALITY DIAGNOSIS THERE ARE A RANGE OF ORGANISATIONS BOTH HERE IN NEW ZEALAND AND GLOBALLY WHO PROVIDE INFORMATION AND SUPPORT FOR FAMILIES EXPECTING A CHILD WITH A DISABILITY.

It is very important to get a perspective on your unborn child’s disability from parents who have a child with that disability and these organisations can help facilitate with these parents.

It is also important to bear in mind that there is a mixed record for the providing of non-directive counselling to those facing a fetal abnornality diagnosis. Many families we have talked to in New Zealand have had mixed experiences with the counselling given by fetal medicine teams and this sentiment does not appear to be unique to New Zealand. In a UK survey by the University of Leeds, only 32% of obstetricians reported counselling pregnant women non-directively, and two researchers recently concluded that all pre-natal counselling is, in reality, directive (1). A father of a baby aborted on grounds of disability said “Our consultant guided us through the decision making process … she made it easier to say yes (to the abortion) knowing it was the only way.”

If you have been offered pre-natal screening it is important that you know about the the risks involved in testing, that you do not have to take the tests and whether there will be a therapeutic benefit for your unborn child from taking the tests.

Below we provide contacts for support organisations for common disabilities and the stories of people living with each of these disabilities. If the diagnosis you have been given is not listed here, please get in contact with us and we will put you in touch with an organisation or family that specialises in supporting parents facing that particular diagnosis.

(1)“Antenatal screening for Down’s syndrome” by Helen Statham and Wendy Solomou. The Lancet 5 December 1998.

COMMON DIAGNOSIS – DOWN SYNDROME

Down’s syndrome is a genetic condition caused by the presence of an extra chromosome in the body’s cells. Down’s syndrome is not a disease, and it is not a hereditary condition. It occurs by chance at conception.

Everyone with Down’s syndrome will have some degree of learning disability. Certain physical characteristics are common among people with Down syndrome, and they can be more prone to certain medical problems. However, the most important thing to remember is that everyone with Down syndrome is an individual, with their own strengths and weaknesses and personality traits that make them  who they are.

Support

SAVING DOWNS

Saving Downs are a New Zealand-based group of parents of children with Down syndrome with a worldwide following. If you are considering screening or are facing a diagnosis, there are regional representatives throughout the country who are available to meet with you.

Saving Downs Facebook page

NEW ZEALAND DOWN SYNDROME ASSOCIATION

The New Zealand Down Syndrome Association is a family/whanau driven organisation for people whose lives have been changed by Down Syndrome. The NZDSA is a support organisation for families. They can put your patient in touch with a family with a member with Down Syndrome.

New Zealand Down Syndrome Association website

PARENT TO PARENT

Matua ki te Matua (Parent to Parent) is a support and information network for parents of children with special needs. Parent to Parent seeks to support, educate and empower families who have a child or family member with disabilities, health impairments or special needs.

Parent to Parent website

INTERNATIONAL DOWN SYNDROME COALITION FOR LIFE (IDSC)

IDSC for Life is dedicated to serving individuals with Down syndrome from conception throughout their lives. They achieve this by supporting families who have been given a prenatal diagnosis of Down syndrome. Of special note is the many Facebook groups that they run for parents at various stages of their journey to get support from other parents who have been through that stage or who are currently going through that stage.

COMMON DIAGNOSIS – SPINA BIFIDA

Spina Bifida is a fault in the spinal column in which one or more veterbrae (the bones which form the backbone) fail to form properly, leaving a gap or split, causing damage to the nervous system.

WHAT ARE THE DIFFERENT TYPES OF SPINA BIFIDA?

Occult Spinal Dysraphism (OSD)
Infants with this have a dimple in their lower back. Because most babies with dimples do not have OSD, a doctor has to check using special tools and tests to be sure. Other signs are red marks, hyperpigmented patches on the back, tufts of hair or small lumps. In OSD, the spinal cord may not grow the right way and can cause serious problems as a child grows up. Infants who might have OSD should be seen by a doctor, who will recommend tests.

Spina Bifida Occulta
It is often called “hidden Spina Bifida” because about 15 percent of healthy people have it and do not know it. Spina Bifida Occulta usually does not cause harm, and has no visible signs. The spinal cord and nerves are usually fine. People find out they have it after having an X-ray of their back. It is considered an incidental finding because the X-Ray is normally done for other reasons. However, in a small group of people with SBO, pain and neurological symptoms may occur. Tethered cord can be an insidious complication that requires investigation by a neurosurgeon.

Meningocele
A meningocele causes part of the spinal cord to come through the spine like a sac that is pushed out. Nerve fluid is in the sac, and there is usually no nerve damage. Individuals with this condition may have minor disabilities.

Myelomeningocele (Meningomyelocele), also called Spina Bifida Cystica
This is the most severe form of Spina Bifida. It happens when parts of the spinal cord and nerves come through the open part of the spine. It causes nerve damage and other disabilities. Seventy to ninety percent of children with this condition also have too much fluid on their brains. This happens because fluid that protects the brain and spinal cord is unable to drain like it should. The fluid builds up, causing pressure and swelling. Without treatment, a person’s head grows too big, and may have brain damage. Children who do not have Spina Bifida can also have this problem, so parents need to check with a doctor.

HOW IS SPINA BIFIDA TREATED?

A child with Meningomyelocele usually is operated on within two to three days of birth. This prevents infections and helps save the spinal cord from more damage.

A child with Meningocele usually has it treated with surgery, and more often than not, the child is not paralyzed. Most children with this condition grow up fine, but they should be checked by a doctor because they could have other serious problems, too.

A child with OSD should see a surgeon. Most experts think that surgery is needed early to keep nerves and the brain from becoming more damaged as the child grows.

NO OTHER LIFE – OUR JOURNEY WITH SPINA BIFIDA

SUPPORT

SPINA BIFIDA ASSOCIATION NEW ZEALAND

Spina Bifida Association New Zealand are a non-profit organisation dedicated to supporting and encouraging parents expecting a baby diagnosed with Spina Bifida and parents of children, young adults and adults living with Spina Bifida.

Spina Bifida Association New Zealand Facebook

PARENT TO PARENT

Matua ki te Matua (Parent to Parent) is a support and information network for parents of children with special needs. Parent to Parent seeks to support, educate and empower families who have a child or family member with disabilities, health impairments or special needs.

Parent to Parent website

Spina Bifida Association (US)

The Spina Bifida Association (SBA) serves adults and children who live with the challenges of Spina Bifida. They are dedicated to enhancing the lives of those with Spina Bifida and those whose lives are touched by this challenging birth defect. Its tools are education, advocacy, research, and service.

They produce many excellent resources on Spina Bifida that are available through their website.

http://www.spinabifidaassociation.org/