Trisomy 13 (Patau Syndrome)

Around 1 in every 10,000 babies is diagnosed with Trisomy 13, also known as Patau syndrome. Normally, a person has 23 pairs of chromosomes. Chromosomes are the packages of genetic information, made of DNA, that contain the instructions the body uses to build a person. Chromosomes come in 23 pairs, with most people having 46 total chromosomes. Trisomy 13 is caused when a person has three copies of chromosome #13 instead of the usual two, for a total of 47 chromosomes.

This extra chromosome affects a baby’s development, resulting in a number of medical issues which may include: heart defects, brain or spinal cord abnormalities, cleft lip and/or cleft palate, extra fingers and toes, vision and hearing problems, seizures and/or hypotonia (weak muscles). All babies that survive with Trisomy 13 have significant intellectual disability (usually in the severe range).

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What You Need to Know About Trisomy 13

There are three types of Trisomy 13:

  1. Full Trisomy 13: The existence of a third copy of chromosome 13 in all of the cells. About 95% of cases of Trisomy 13 are this type.
  2. Mosaic Trisomy 13: The existence of a third copy of chromosome 13 in some of the cells. About 5% of cases of Trisomy 13 are this type.
  3. Partial Trisomy 13: The existence of a part of a third copy of chromosome 13 in the cells. Less than 1% of cases of Trisomy 13 are this type.

When a couple has a baby with Trisomy 13, it is usually unexpected. Nevertheless, some risk factors exist. For example, the chance of having a baby with Trisomy 13 is higher in older mothers. In other cases, Trisomy 13 can be inherited due to a familial chromosome rearrangement called a translocation. Trisomy 13 is never the result of anything a mother or father did, or didn’t do.

Pregnancies at increased risk for Trisomy 13 can be identified through screening tests such as non-invasive prenatal testing (NIPT) and ultrasound examinations. The diagnosis can be confirmed prenatally with better than 99% accuracy through chorionic villus sampling (CVS) or amniocentesis. Both of these advanced diagnostics tests are available at the Cardinal Glennon St. Louis Fetal Care Institute. The diagnosis can also be confirmed shortly after birth through blood testing.

When you visit the Cardinal Glennon St. Louis Fetal Care Institute with a presumed diagnosis of Trisomy 13 your baby you have the opportunity to meet with a team of experts who can provide information about your baby’s diagnosis. This will involve maternal-fetal medicine specialists, genetic counselors, clinical geneticists, social workers, Footprints coordinators and neonatologists. Additionally, based on your unique pregnancy, you may have follow-up visits with other pediatric specialists.

In most cases, a detailed fetal ultrasound will be performed during your first visit to the Cardinal Glennon St. Louis Fetal Care Institute. Amniocentesis is also available if this test has not been performed yet.

A Cardinal Glennon St. Louis Fetal Care Institute nurse coordinator will serve as your primary contact and will coordinate the care of you and your baby throughout the pregnancy.

The goal of the Cardinal Glennon St. Louis Fetal Care Institute team is to provide families with the support, information, knowledge and options to make the decision that is best for their baby. We recognize that the diagnosis of Trisomy 13 affects a family greatly and our hope is to be able to provide families with the resources they need during a difficult and overwhelming time.

Babies with Trisomy 13 can have multiple life-threatening medical issues at birth and throughout their lives. In addition to having birth defects and cognitive impairment, many of babies with Trisomy 13 pass away before they are born. Of those who are born alive, few are expected to survive the first year of life. We don’t know why many of these babies pass away before birth or within their first year of life.

Because every family’s situation is different, the Cardinal Glennon St. Louis Fetal Care Institute brings together an experienced team of specialists to meet with families to provide information, answer questions and prepare them for the birth of their unique baby.

Even though there is no cure for Trisomy 13, there are medical treatments that may be provided after birth that may improve the quality and duration of life for these babies. There is no known prenatal treatment that will improve the outcome for a baby with Trisomy 13, but our team can provide a family with support, education and a safe environment in which to receive their care. Furthermore, treatment after birth may be available for some of the birth defects caused by Trisomy 13.

The diagnosis of Trisomy 13 is just the beginning of a journey that can be challenging for any family. Our goal is to provide the information and options available for these babies and their families, and to be there as a support system throughout the pregnancy and beyond.

The team at the Cardinal Glennon St. Louis Fetal Care Institute will help the family develop a plan of care for the pregnancy and immediate newborn period. That plan can include the presence of the newborn medicine team at delivery to assess the baby’s medical issues and assist with the transition after delivery.

The decisions facing families at the time of the diagnosis of Trisomy 13 and throughout the pregnancy are difficult and personal. We strive to provide the options, resources, information and support to help families make the decisions that respect and reflect their wishes on their child’s behalf.

Because of the complex nature of Trisomy 13, babies often face medical challenges during delivery and in the newborn period. Every baby’s situation is different, and the Cardinal Glennon St. Louis Fetal Care Institute works with each family to prepare for their baby’s delivery and to create a care plan to follow after birth. This plan can include medical interventions or be restricted to comfort measures, depending on the baby’s medical condition and the desires of the family.

Babies with Trisomy 13 have varied outcomes. For some, the medical challenges they face will be significant enough that they will pass away shortly after delivery, while a small number of families can go on to celebrate their baby’s first birthdays and beyond. Babies that survive the newborn period will have significant cognitive impairment and other medical issues that will require advanced care throughout life. The pediatric specialists at SSM Health Cardinal Glennon Children’s Hospital remain available to provide the best possible care for every baby with Trisomy 13 from birth and beyond.

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