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Anencephaly

Anencephaly is a cephalic disorder that results from a neural tube defect that occurs when the cephalic (head) end of the neural tube fails to close, usually between the 23rd and 26th day of pregnancy, resulting in the absence of a major portion of the brain, skull, and scalp. Infants with this disorder are born without a forebrain - the largest part of the brain consisting mainly of the cerebrum - which is responsible for thinking and coordination. The remaining brain tissue is often exposed - not covered by bone or skin. more...

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Infants born with anencephaly are usually blind, deaf, unconscious, and unable to feel pain. Although some individuals with anencephaly may be born with a rudimentary brainstem, which controls autonomic and regulatory function, the lack of a functioning cerebrum permanently rules out the possibility of ever gaining consciousness. Reflex actions such as respiration (breathing) and responses to sound or touch may occur. The disorder is one of the most common disorders of the fetal central nervous system.

There is no cure or standard treatment for anencephaly and the prognosis for affected individuals is poor. Most anencephalic babies do not survive birth. If the infant is not stillborn, then he or she will usually die within a few hours or days after birth. Anencephaly can often be diagnosed before birth through an ultrasound examination. The maternal serum alpha-fetoprotein (AFP screening) and detailed fetal ultrasound can be useful for screening for neural tube defects such as spina bifida or anencephaly.

In the United States, approximately 1,000 to 2,000 babies are born with anencephaly each year. Female babies are more likely to be affected by the disorder. About 95% of women who learn that they will have an anencephalic baby choose to have an abortion. Of the remaining 5%, about 55% are stillborn. The rest usually live only a few hours or days.

In almost all cases anencephalic infants are not aggressively resuscitated since there is no chance of the infant ever achieving a conscious existence. Instead, the usual clinical practice is to offer hydration, nutrition and comfort measures and to "let nature take its course". Artificial ventilation, surgery (to fix any co-existing congenital defects), and drug therapy (such as antibiotics) are usually regarded as being pointless. Some clinicians see no point in even providing nutrition and hydration, arguing that euthanasia is morally and clinically appropriate in such cases.

The cause of anencephaly is unknown. Neural tube defects do not follow direct patterns of heredity. Studies show that a woman who has had one child with a neural tube defect such as anencephaly, has about a 3% risk to have another child with a neural tube defect. This risk can be reduced to about 1% if the woman takes high dose (4mg/day) folic acid before and during pregnancy.

It is known that women taking certain medication for epilepsy and women with insulin dependant diabetes have a higher chance of having a child with a neural tube defect. Genetic counseling is usually offered to women at a higher risk of having a child with a neural tube defect to discuss available testing.

Recent studies have shown that the addition of folic acid to the diet of women of child-bearing age may significantly reduce, although not eliminate, the incidence of neural tube defects. Therefore, it is recommended that all women of child-bearing age consume 0.4 mg of folic acid daily, especially those attempting to conceive or who may possibly conceive. It is foolhardy to wait until pregnancy has begun, since by the time a woman knows she is pregnant, the critical time for the formation of a neural tube defect has usually already passed. A physician may prescribe even higher dosages of folic acid (4mg/day) for women who have had a previous pregnancy with a neural tube defect.

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Georgia miracle baby defies odds by simply surviving - Newsmakers - Brief Article
From Jet, 3/4/02

While in her second trimester of motherhood Margo Laugand-Shabazz of Lithonia, GA, was advised to terminate the pregnancy of her unborn child. Because she refused to follow the doctors' advice, she is now the proud mother of a daughter who has defied the odds of medicine simply because she continues to live.

After an ultrasound during a typical prenatal check-up, 32-year-old Laugand-Shabazz and her husband, Abdur Rahim Shabazz, were told that their unborn child was diagnosed with the birth defect anencephaly.

According to the National Institute of Neurological Disorders and Stroke, the medical condition is a disorder involving incomplete development of the brain, spinal cord and/or their protective coverings. The result is the absence of a major portion of the brain, skull and scalp. The cause is unknown but some experts believe that the birth defect is due to a lack of folic acid in the mother's diet.

Doctors advised the couple, who already have four other children (two from Abdur's previous marriage), to terminate the pregnancy. Despite the devastating news Laugand-Shabazz and her husband refused the recommendation.

"I don't believe in abortion," says Laugand-Shabazz of the forewarning. "It was never a thought for me to consider. We both said that terminating the pregnancy was out of the question."

Doctors told the expectant mother that her child would most likely be stillborn or die within a few hours of birth, which is typical for ancephalic babies.

With love from family and friends the couple continued to go through the traditional steps of the pregnancy.

On March 26 of last year, Faith Aminah Shabazz came into the world weighing 7 pounds, 12.4 ounces. When she was born a large protrusion of brain tissue, or an encephalocele, sat on the outside of her head.

The doctors told the family to spend as much time as possible with the baby because she would die shortly. Even though they were aware of the circumstances and the history of the disease, the family remained optimistic and hoped for the best.

Defying the odds against her, Faith survived and after three days she and her mother were discharged from the hospital.

Laugand-Shabazz had the baby transferred to another hospital to have the encephalocele surgically removed. Following the procedure the neurosurgeon there sadly predicted that Faith would survive for only a few more days.

There is no medical proof, but Laugand-Shabazz thinks that the operation has helped her daughter live longer.

"The encephalocele was already infected," Laugand-Shabazz explains. "If I would have brought her home, it could have infected the rest of her body, so I had them remove it."

Laugand-Shabazz, a stay-at-home mom, says that she cares for Faith like a mother would any other normal baby. "Besides the abnormality, she's not a sickly child."

Since birth Faith has only been hospitalized once, for a case of pneumonia. Otherwise, Laugand-Shabazz schedules appointments with various specialists for the baby's breathing and diet as needed.

Babies born with this condition are usually blind, deaf, unconscious and unable to feel pain. Faith, however, can see, but doctors are not certain how far. According to her mother the infant also cries, smiles and knows when she's being spoken to. She even tries to scoot when she is placed on the floor.

"We knew our baby was a fighter since day one," says the proud mom. "The doctors don't really do a whole lot for her because they don't know what to do. She's already outlived her expectancy.

"They've even come out and said, `Well she's probably going to die soon. Just give her a few more weeks and don't get too attached.'"

As Faith nears her first birthday this month, physicians are still baffled as to how or why she has managed to live as long as she has.

Neurosurgeons have told Laugand-Shabazz that as Faith and technology progress there is hope that the infant can receive some type of reconstructive surgery by the age of 2.

"With God all things are possible, and Faith's presence is truly a blessing from God," says Laugand-Shabazz. "We all have a purpose here on earth. We may not see it when we want to, but when God reveals the veil, then we shall see."

COPYRIGHT 2002 Johnson Publishing Co.
COPYRIGHT 2002 Gale Group

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