Trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome) have historically been regarded as “uniformly lethal” or “incompatible with life,” leading to the longstanding practice of withholding resuscitation and surgical intervention. However, accumulating evidence indicates that survival is more heterogeneous than previously recognized, and advances in neonatal and surgical care have improved outcomes. Among long-term survivors, gradual yet meaningful developmental progress has been observed, and parental reports describe affected children as happy and deeply valued members of their families. These findings have reshaped clinical and ethical perspectives, fostering a paradigm shift from uniform non-intervention toward individualized, family-centered decision-making. In parallel, the widespread adoption of noninvasive prenatal screening (NIPS) has markedly increased prenatal detection, further complicating perinatal counseling and underscoring the need for ethically consistent care. This narrative review summarizes current and evolving evidence on survival and treatment outcomes for trisomy 18 and trisomy 13 and synthesizes contemporary approaches to comprehensive care from the neonatal period through childhood. Within this evolving landscape, we propose a practical framework for counseling and iterative shared decision-making with families. Integrating accurate and up-to-date medical information with family perspectives is essential to provide compassionate, balanced, and equitable care for infants with these syndromes and their families.
CareyJC. Trisomy 18 and trisomy 13 syndromes. In: CareyJCBattagliaAViskochilD, et al. (eds) Cassidy and Allanson’s Management of Genetic Syndromes. 4th ed.John Wiley & Sons, 2020, pp. 937–956.
4.
SpringettAWellesleyDGreenleesR, et al.Congenital anomalies associated with trisomy 18 or trisomy 13: a registry-based study in 16 European countries, 2000–2011. Am J Med Genet A2015; 167A(12): 3062–3069. https://doi.org/10.1002/ajmg.a.37355
5.
GoelNMorrisJKTuckerD, et al.Trisomy 13 and 18-prevalence and mortality-a multi-registry population based analysis. Am J Med Genet A2019; 179(12): 2382–2392. https://doi.org/10.1002/ajmg.a.61365
6.
NelsonKERosellaLCMahantS, et al.Survival and surgical interventions for children with trisomy 13 and 18. JAMA2016; 316(4): 420–428. https://doi.org/10.1001/jama.2016.9819
7.
KosivKAGossettJMBaiS, et al.Congenital heart surgery on in-hospital mortality in trisomy 13 and 18. Pediatrics2017; 140(5): e20170772. https://doi.org/10.1542/peds.2017-0772
ForresterMBMerzRD. Trisomies 13 and 18: prenatal diagnosis and epidemiologic studies in Hawaii, 1986–1997. Genet Test1999; 3(4): 335–340. https://doi.org/10.1089/gte.1999.3.335
10.
WilleyEKFeldkampMLKrikovS, et al.Analysis of trisomy 13 and trisomy 18: findings from a population-based study in Utah, 1990–2006. In: Pediatric academic societies annual meeting, Honolulu, HI, 2–6 May 2008. Poster presentation.
11.
CriderKSOlneyRSCraganJD. Trisomies 13 and 18: population prevalences, characteristics, and prenatal diagnosis, metropolitan Atlanta, 1994–2003. Am J Med Genet A2008; 146A(7): 820–826. https://doi.org/10.1002/ajmg.a.32200
12.
IrvingCRichmondSWrenC, et al.Changes in fetal prevalence and outcome for trisomies 13 and 18: a population-based study over 23 years. J Matern Fetal Neonatal Med2011; 24(1): 137–141. https://doi.org/10.3109/14767051003758879
13.
LoaneMMorrisJKAddorMC, et al.Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe: impact of maternal age and prenatal screening. Eur J Hum Genet2013; 21(1): 27–33. https://doi.org/10.1038/ejhg.2012.94
GoldsteinHNielsenKG. Rates and survival of individuals with trisomy 13 and 18. Data from a 10-year period in Denmark. Clin Genet1988; 34(6): 366–372. https://doi.org/10.1111/j.1399-0004.1988.tb02894.x
EmbletonNDWyllieJPWrightMJ, et al.Natural history of trisomy 18. Arch Dis Child Fetal Neonatal Ed1996; 75(1): F38–F41. https://doi.org/10.1136/fn.75.1.f38
18.
MorrisJKSavvaGM. The risk of fetal loss following a prenatal diagnosis of trisomy 13 or trisomy 18. Am J Med Genet A2008; 146A(7): 827–832. https://doi.org/10.1002/ajmg.a.32220
19.
RasmussenSAWongLYYangQ, et al.Population-based analyses of mortality in trisomy 13 and trisomy 18. Pediatrics2003; 111(4 Pt 1): 777–784. https://doi.org/10.1542/peds.111.4.777
MaiCTIsenburgJLCanfieldMA, et al.National population-based estimates for major birth defects, 2010–2014. Birth Defects Res2019; 111(18): 1420–1435. https://doi.org/10.1002/bdr2.1589
22.
CarterPEPearnJHBellJ, et al.Survival in trisomy 18. Life tables for use in genetic counselling and clinical paediatrics. Clin Genet1985; 27(1): 59–61. https://doi.org/10.1111/j.1399-0004.1985.tb00184.x
23.
AlbermanEMuttonDMorrisJK. Cytological and epidemiological findings in trisomies 13, 18, and 21: England and Wales 2004–2009. Am J Med Genet A2012; 158A(5): 1145–1150. https://doi.org/10.1002/ajmg.a.35337
24.
FisherJMHarveyJFMortonNE, et al.Trisomy 18: studies of the parent and cell division of origin and the effect of aberrant recombination on nondisjunction. Am J Hum Genet1995; 56(3): 669–675.
25.
EggermannTNöthenMMEibenB, et al.Trisomy of human chromosome 18: molecular studies on parental origin and cell stage of nondisjunction. Hum Genet1996; 97(2): 218–223. https://doi.org/10.1007/BF02265269
26.
PeronACareyJC. Molecular genetics of trisomy 18: phenotype, genotype correlations. Wiley Online Library, 2014. https://doi.org/10.1002/9780470015902.a0025246 (accessed 7 November 2025).
TharapelSALewandowskiRCTharapelAT, et al.Phenotype-karyotype correlation in patients trisomic for various segments of chromosome 13. J Med Genet1986; 23(4): 310–315. https://doi.org/10.1136/jmg.23.4.310
29.
RibacobaRMenendez-GonzalezMHernandoI, et al.Partial trisomy 13q22-qter associated to leukoencephalopathy and late onset generalised epilepsy. Int Arch Med2008; 1(1): 5. https://doi.org/10.1186/1755-7682-1-5
30.
MachadoINHeinrichJKCampanholC, et al.Prenatal diagnosis of a partand molecular characterization by spectral karyotyping and array comparative genomic hybridization. Genet Mol Res2010; 9(1): 441–448. https://doi.org/10.4238/vol9-1gmr716
31.
BatyBJBlackburnBLCareyJC. Natural history of trisomy 18 and trisomy 13: I. Growth, physical assessment, medical histories, survival, and recurrence risk. Am J Med Genet1994; 49(2): 175–188. https://doi.org/10.1002/ajmg.1320490204
32.
UeharaSYaegashiNMaedaT, et al.Risk of recurrence of fetal chromosomal aberrations: analysis of trisomy 21, trisomy 18, trisomy 13, and 45,X in 1,076 Japanese mothers. J Obstet Gynaecol Res1999; 25(6): 373–379. https://doi.org/10.1111/j.1447-0756.1999.tb01180.x
33.
VioraEZamboniCMortaraG, et al.Trisomy 18: fetal ultrasound findings at different gestational ages. Am J Med Genet A2007; 143A(6): 553–557. https://doi.org/10.1002/ajmg.a.31615
34.
TongsongTSirichotiyakulSWanapirakC, et al.Sonographic features of trisomy 13 at midpregnancy. Int J Gynaecol Obstet2002; 76(2): 143–148. https://doi.org/10.1016/s0020-7292(01)00571-9
35.
GhaffariSRTahmasebpourARJamalA, et al.First-trimester screening for chromosomal abnormalities by integrated application of nuchal translucency, nasal bone, tricuspid regurgitation and ductus venosus flow combined with maternal serum free β-hCG and PAPP-A: a 5-year prospective study. Ultrasound Obstet Gynecol2012; 39(5): 528–534. https://doi.org/10.1002/uog.10051
36.
Karadzov-OrlicNEgicAMilovanovicZ, et al.Improved diagnostic accuracy by using secondary ultrasound markers in the first-trimester screening for trisomies 21, 18 and 13 and Turner syndrome. Prenat Diagn2012; 32(7): 638–643. https://doi.org/10.1002/pd.3873
37.
WiechecMKnafelANocunA, et al.How effective is ultrasound-based screening for trisomy 18 without the addition of biochemistry at the time of late first trimester?J Perinat Med2016; 44(2): 149–159. https://doi.org/10.1515/jpm-2014-0384
38.
WagnerPSonekJHoopmannM, et al.First-trimester screening for trisomies 18 and 13, triploidy and Turner syndrome by detailed early anomaly scan. Ultrasound Obstet Gynecol2016; 48(4): 446–451. https://doi.org/10.1002/uog.15829
39.
RoseNCBarrieESMalinowskiJ, et al.Systematic evidence-based review: the application of noninvasive prenatal screening using cell-free DNA in general-risk pregnancies. Genet Med2022; 24(7): 1379–1391. https://doi.org/10.1016/j.gim.2022.07.002
ParisJJWeissAHSoiferS. Ethical issues in the use of life-prolonging interventions for an infant with trisomy 18. J Perinatol1992; 12(4): 366–368.
43.
MeyerRELiuGGilboaSM, et al.Survival of children with trisomy 13 and trisomy 18: a multi-state population-based study. Am J Med Genet A2016; 170A(4): 825–837. https://doi.org/10.1002/ajmg.a.37495
44.
KoshoTNakamuraTKawameH, et al.Neonatal management of trisomy 18: clinical details of 24 patients receiving intensive treatment. Am J Med Genet A2006; 140(9): 937–944. https://doi.org/10.1002/ajmg.a.31175
45.
GrahamEMBradleySMShiraliGS, et al.Effectiveness of cardiac surgery in trisomies 13 and 18 (from the pediatric cardiac care consortium). Am J Cardiol2004; 93(6): 801–803. https://doi.org/10.1016/j.amjcard.2003.12.012
46.
KanekoYKobayashiJYamamotoY, et al.Intensive cardiac management in patients with trisomy 13 or trisomy 18. Am J Med Genet A2008; 146A(11): 1372–1380. https://doi.org/10.1002/ajmg.a.32311
KobayashiJKanekoYYamamotoY, et al.Radical surgery for a ventricular septal defect associated with trisomy 18. Gen Thorac Cardiovasc Surg2010; 58(5): 223–227. https://doi.org/10.1007/s11748-009-0431-3
49.
MuneuchiJYamamotoJTakahashiY, et al.Outcomes of cardiac surgery in trisomy 18 patients. Cardiol Young2011; 21(2): 209–215. https://doi.org/10.1017/S1047951110001848
50.
CostelloJPWeiderholdALouisC, et al.A contemporary, single-institutional experience of surgical versus expectant management of congenital heart disease in trisomy 13 and 18 patients. Pediatr Cardiol2015; 36(5): 987–992. https://doi.org/10.1007/s00246-015-1109-5
51.
NakaiYAsanoMNomuraN, et al.Effectiveness of cardiac surgery in patients with trisomy 18: a single-institutional experience. Cardiol Young2016; 26(7): 1391–1396. https://doi.org/10.1017/S1047951115002723
52.
PetersonJKKochilasLKCattonKG, et al.Long-term outcomes of children with trisomy 13 and 18 after congenital heart disease interventions. Ann Thorac Surg2017; 103(6): 1941–1949. https://doi.org/10.1016/j.athoracsur.2017.02.068
53.
DavissonNAClarkJBChinTK, et al.Trisomy 18 and congenital heart disease: single-center review of outcomes and parental perspectives. World J Pediatr Congenit Heart Surg2018; 9(5): 550–556. https://doi.org/10.1177/2150135118782145
54.
DomingoLCareyJCEckhauserA, et al.Mortality and resource use following cardiac interventions in children with trisomy 13 and trisomy 18 and congenital heart disease. Pediatr Cardiol2019; 40(2): 349–356. https://doi.org/10.1007/s00246-018-2001-x
55.
CooperDSRiggsKWZafarF, et al.Cardiac surgery in patients with trisomy 13 and 18: an analysis of the society of thoracic surgeons congenital heart surgery database. J Am Heart Assoc2019; 8(13): e012349. https://doi.org/10.1161/JAHA.119.012349
56.
NakaiRFujiokaTOkamuraK, et al.Survival outcomes of two-stage intracardiac repair in large ventricular septal defect and trisomy 18. Pediatr Cardiol2021; 42(4): 821–831. https://doi.org/10.1007/s00246-021-02546-9
57.
SongIGShinSHChoYM, et al.Survival of children with trisomy 18 associated with the presence of congenital heart disease and intervention in the Republic of Korea. BMC Pediatr2023; 23(1): 252. https://doi.org/10.1186/s12887-023-04056-4
58.
TakaiAYamagishiMIkedaK, et al.Effectiveness of cardiac palliative surgery for trisomy 18 patients with increased pulmonary blood flow. Am J Med Genet A2023; 191(11): 2703–2710. https://doi.org/10.1002/ajmg.a.63401
59.
GreenbergJWKulshresthaKRamineniA, et al.Contemporary trends in cardiac surgical care for trisomy 13 and 18 patients admitted to hospitals in the United States. J Pediatr2024; 268: 113955. https://doi.org/10.1016/j.jpeds.2024.113955
60.
GreeneCLSchulzAChávezM, et al.Operative and nonoperative outcomes in patients with trisomy 13 and 18 with congenital heart disease. JTCVS Open2024; 20: 123–131. https://doi.org/10.1016/j.xjon.2024.06.007
61.
NemotoSTachimoriHKoshoT, et al.Current nationwide landscape of cardiac surgery for children with trisomy 18 in Japan. Am J Med Genet A2026; 200(1): 77–83. https://doi.org/10.1002/ajmg.a.64232
62.
CortezzoDETolussoLKSwarrDT. Perinatal outcomes of fetuses and infants diagnosed with trisomy 13 or trisomy 18. J Pediatr2022; 247: 116–123.e5. https://doi.org/10.1016/j.jpeds.2022.04.010
63.
JanvierAFarlowBWilfondBS. The experience of families with children with trisomy 13 and 18 in social networks. Pediatrics2012; 130(2): 293–298. https://doi.org/10.1542/peds.2012-0151
64.
KoshoTKunibaHTanikawaY, et al.Natural history and parental experience of children with trisomy 18 based on a questionnaire given to a Japanese trisomy 18 parental support group. Am J Med Genet A2013; 161A(7): 1531–1542. https://doi.org/10.1002/ajmg.a.35990
65.
MurphyNAlveyJCBrintonJ, et al.Healthcare delivery for children with medical complexity: the state of the art and future directions. : Springer Nature Switzerland, 2025.
KeppleJWFishlerKPPeeplesES. Surveillance guidelines for children with trisomy 18. Am J Med Genet A2021; 185(4): 1294–1303. https://doi.org/10.1002/ajmg.a.62097
68.
KeppleJWFishlerKPPeeplesES. Surveillance guidelines for children with trisomy 13. Am J Med Genet A2021; 185(5): 1631–1637. https://doi.org/10.1002/ajmg.a.62133
69.
KosivKAMercurioMRCareyJC. The common trisomy syndromes, their cardiac implications, and ethical considerations in care. Curr Opin Pediatr2023; 35(5): 531–537. https://doi.org/10.1097/MOP.0000000000001278
70.
St LouisJDBhatACareyJC, et al.The American Association for Thoracic Surgery (AATS) 2023 expert consensus document: recommendation for the care of children with trisomy 13 or trisomy 18 and a congenital heart defect. J Thorac Cardiovasc Surg2024; 167(5): 1519–1532. https://doi.org/10.1016/j.jtcvs.2023.11.054
71.
TamakiSIwataniSIzumiA, et al.Improving survival in patients with trisomy 18. Am J Med Genet A2022; 188(4): 1048–1055. https://doi.org/10.1002/ajmg.a.62605
72.
Van PraaghSTrumanTFirpoA, et al.Cardiac malformations in trisomy-18: a study of 41 postmortem cases. J Am Coll Cardiol1989; 13(7): 1586–1597. https://doi.org/10.1016/0735-1097(89)90353-7
73.
TaharaMShimozonoSNittaT, et al.Medial defects of the small pulmonary arteries in fatal pulmonary hypertension in infants with trisomy 13 and trisomy 18. Am J Med Genet A2014; 164A(2): 319–323. https://doi.org/10.1002/ajmg.a.36282
74.
TaharaMSanadaKMoritaR, et al.Insufficient development of vessels and alveoli in lungs of infants with trisomy 18-Features of pulmonary histopathological findings from lung biopsy. Am J Med Genet A2021; 185(4): 1059–1066. https://doi.org/10.1002/ajmg.a.62060
75.
PetersonRCalamurNFioreA, et al.Factors influencing outcomes after cardiac intervention in infants with trisomy 13 and 18. Pediatr Cardiol2018; 39(1): 140–147. https://doi.org/10.1007/s00246-017-1738-y
76.
CarvajalHGCallahanCPMillerJR, et al.Cardiac surgery in trisomy 13 and 18: a guide to clinical decision-making. Pediatr Cardiol2020; 41(7): 1319–1333. https://doi.org/10.1007/s00246-020-02444-6
77.
DressCSilvaCTvon AllmenDC, et al.Airway findings in trisomy 13 and trisomy 18: a 10-year retrospective review. Pediatr Pulmonol2024; 59(2): 342–347. https://doi.org/10.1002/ppul.26750
78.
GreenGE. Newborn airway evaluation and mandibular distraction in trisomy 18. SOFT 2021 virtual conference professionals panel. YouTube. https://www.youtube.com/watch?v=M-whoQ10EKc (2021, accessed 7 November 2025).
79.
KettlerEBBhattacharjeeRLesserD, et al.Sleep disordered breathing in children with trisomy 13 and trisomy 18. Am J Otolaryngol2020; 41(6): 102555. https://doi.org/10.1016/j.amjoto.2020.102555
80.
BensonJStewartCKennaMA, et al.Otolaryngologic manifestations of trisomy 13 and trisomy 18 in pediatric patients. Laryngoscope2023; 133(6): 1501–1506. https://doi.org/10.1002/lary.30350
SpagnoliCKugathasanUBrittainH, et al.Epileptic spasms and early-onset photosensitive epilepsy in Patau syndrome: an EEG study. Brain Dev2015; 37(7): 704–713. https://doi.org/10.1016/j.braindev.2014.10.007
83.
TairaRInoueHSawanoT, et al.Management of apnea in infants with trisomy 18. Dev Med Child Neurol2020; 62(7): 874–878. https://doi.org/10.1111/dmcn.14403
84.
JaspersenSLBrunsDACandeeMS, et al.Seizures in trisomy 18: prevalence, description, and treatment. Am J Med Genet A2023; 191(4): 1026–1037. https://doi.org/10.1002/ajmg.a.63113
85.
TamakiSIwataniSHagimotoS, et al.Impact of tracheostomies on the long-term survival of patients with trisomy 13 syndrome. Am J Med Genet A2023; 191(11): 2736–2742. https://doi.org/10.1002/ajmg.a.63393
FukasawaTKubotaTTanakaM, et al.Apneas observed in trisomy 18 neonates should be differentiated from epileptic apneas. Am J Med Genet A2015; 167A(3): 602–606. https://doi.org/10.1002/ajmg.a.36929
88.
MorelliSBarnesACareyJC. A series of older children with trisomy 13. J Investig Med2000; 48(1 Suppl): 47A.
89.
BoghossianNSHorbarJDMurrayJC, et al.Anthropometric charts for infants with trisomies 21, 18, or 13 born between 22 weeks gestation and term: the VON charts. Am J Med Genet A2012; 158A(2): 322–332. https://doi.org/10.1002/ajmg.a.34423
90.
MannavaSVMuraruRMesfinFM, et al.Gastrostomy tube placement in patients with trisomy 13 and 18: surgical decision making and outcomes. J Pediatr Surg2025; 60(5): 162249. https://doi.org/10.1016/j.jpedsurg.2025.162249
91.
BermanLBairdRSant'AnnaA, et al.Gastrostomy tube use in pediatrics: a systematic review. Pediatrics2022; 149(6): e2021055213. https://doi.org/10.1542/peds.2021-055213
92.
KatoEKitaseYTachibanaT, et al.Factors related to survival discharge in trisomy 18: a retrospective multicenter study. Am J Med Genet A2019; 179(7): 1253–1259. https://doi.org/10.1002/ajmg.a.61146
93.
NishiETakamizawaSIioK, et al.Surgical intervention for esophageal atresia in patients with trisomy 18. Am J Med Genet A2014; 164A(2): 324–330. https://doi.org/10.1002/ajmg.a.36294
94.
TamakiSIwataniSIkutaT, et al.Impact of definitive surgery for esophageal atresia on long-term outcomes in patients with trisomy 18. Am J Med Genet A2024; 194(11): e63792. https://doi.org/10.1002/ajmg.a.63792
95.
KeppleJWPeeplesES. Direct hyperbilirubinemia and cholestasis in trisomy 13 and 18. Am J Med Genet A2022; 188(2): 548–555. https://doi.org/10.1002/ajmg.a.62552
96.
BatyBJJordeLBBlackburnBL, et al.Natural history of trisomy 18 and trisomy 13: II. Psychomotor development. Am J Med Genet1994; 49(2): 189–194. https://doi.org/10.1002/ajmg.1320490205
97.
BrunsD. Birth history, physical characteristics, and medical conditions in long-term survivors with full trisomy 13. Am J Med Genet A2011; 155A(11): 2634–2640. https://doi.org/10.1002/ajmg.a.34283
98.
BraddockBMcDanielJSpraggeS, et al.Communication ability in persons with trisomy 18 and trisomy 13. Augment Altern Commun2012; 28(4): 266–277. https://doi.org/10.3109/07434618.2012.706637
99.
LiangCABraddockBAHeithausJL, et al.Reported communication ability of persons with trisomy 18 and trisomy 13. Dev Neurorehabilit2015; 18(5): 322–329. https://doi.org/10.3109/17518423.2013.847980
100.
WeaverMSAndersonVBeckJ, et al.Interdisciplinary care of children with trisomy 13 and 18. Am J Med Genet A2021; 185(3): 966–977. https://doi.org/10.1002/ajmg.a.62051
TamakiSIwataniSKatsunumaS, et al.Characteristics of hearing impairment in patients with trisomy 18. Am J Med Genet A2024; 194(1): 107–110. https://doi.org/10.1002/ajmg.a.63358
104.
SatoRYoshimuraHKoshoT, et al.Cause, severity, and efficacy of treatment for hearing loss in children with trisomy 18: a single institution-based retrospective study. Am J Med Genet A2024; 194(4): e63492. https://doi.org/10.1002/ajmg.a.63492
105.
WiedmeierSEHenryEChristensenRD. Hematological abnormalities during the first week of life among neonates with trisomy 18 and trisomy 13: data from a multi-hospital healthcare system. Am J Med Genet A2008; 146A(3): 312–320. https://doi.org/10.1002/ajmg.a.32107
106.
CareyJCBarnesAM. Wilms tumor and trisomy 18: is there an association?Am J Med Genet C Semin Med Genet2016; 172(3): 307–308. https://doi.org/10.1002/ajmg.c.31523
107.
SatgéDNishiMSirventN, et al.A tumor profile in Edwards syndrome (trisomy 18). Am J Med Genet C Semin Med Genet2016; 172(3): 296–306. https://doi.org/10.1002/ajmg.c.31511
108.
FarmakisSGBarnesAMCareyJC, et al.Solid tumor screening recommendations in trisomy 18. Am J Med Genet A2019; 179(3): 455–466. https://doi.org/10.1002/ajmg.a.61029
109.
ZiogasIAKakosCDKokkinakisS, et al.Management and outcomes of hepatoblastoma in patients with trisomy 18: a systematic review and pooled analysis of 70 patients. J Pediatr Surg2024; 59(10): 161596. https://doi.org/10.1016/j.jpedsurg.2024.06.005
110.
JanvierAFarlowBBarringtonKJ. Parental hopes, interventions, and survival of neonates with trisomy 13 and trisomy 18. Am J Med Genet C Semin Med Genet2016; 172(3): 279–287. https://doi.org/10.1002/ajmg.c.31526
GuonJWilfondBSFarlowB, et al.Our children are not a diagnosis: the experience of parents who continue their pregnancy after a prenatal diagnosis of trisomy 13 or 18. Am J Med Genet A2014; 164A(2): 308–318. https://doi.org/10.1002/ajmg.a.36298
113.
JanvierAFarlowBBarringtonKJ, et al.Building trust and improving communication with parents of children with trisomy 13 and 18: a mixed-methods study. Palliat Med2020; 34(3): 262–271. https://doi.org/10.1177/0269216319860662
114.
PyleAKGeorgeTNCummingsJJ, et al.Guidance for caring for infants and children with trisomy 13 and trisomy 18: clinical report. Pediatrics2025; 156(2): e2025072719. https://doi.org/10.1542/peds.2025-072719
115.
PetersenAKCheungSWSmithJL, et al.Positive predictive value estimates for cell-free noninvasive prenatal screening from data of a large referral genetic diagnostic laboratory. Am J Obstet Gynecol2017; 217(6): 691.e1–691.e6. https://doi.org/10.1016/j.ajog.2017.10.005
AndrewsSEDowneyAGShowalterDS, et al.Shared decision making and the pathways approach in the prenatal and postnatal management of the trisomy 13 and trisomy 18 syndromes. Am J Med Genet C Semin Med Genet2016; 172(3): 257–263. https://doi.org/10.1002/ajmg.c.31524
118.
HaugSGoldsteinMCumminsD, et al.Using patient-centered care after a prenatal diagnosis of trisomy 18 or trisomy 13: a review. JAMA Pediatr2017; 171(4): 382–387. https://doi.org/10.1001/jamapediatrics.2016.4798
