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Successful tissue donation in the anencephalic baby

02 April 2016
6 min read
Volume 24 · Issue 4

Abstract

Anencephaly is a rare phenomenon, occurring in 4.7/10 000 births, which results from failure of primary neural tube closure during fetal development (Collins et al, 2013). It is a lethal condition comprising absence of skull bones, forebrain and upper brainstem. The cranial neural tissue is exposed (Tasker et al, 2013). The aetiology of this condition is unknown (Stumpf et al, 1990). Many congenital defects are now diagnosed by antenatal diagnosis as early as 11 weeks' gestation (Sadler, 2012). A severe lesion, such as that found in the two cases reported in this article, is incompatible with life. This article reports on two consecutive cases of anencephaly at the same hospital, in which both sets of parents independently wished to continue their pregnancies till term in order to provide tissue donation, primarily heart valves. The donation of other organs may be considered in cases of anencephaly, although this is not always possible.

Anencephaly is a defect in the closure of the neural tube during the fourth week of gestation, occurring in 4.7/10 000 births (Collins et al, 2013). The neural tube is a narrow channel that folds and closes between 24–26 days post-fertilisation to form the brain and spinal cord of the embryo (Coady and Bower, 2015). Anencephaly occurs when the cephalic or head end of the neural tube fails to close, resulting in the absence of a major portion of the brain, skull and scalp. Infants with this disorder are born without a forebrain and cerebrum (the thinking and coordinating part of the brain). The remaining brain tissue is often exposed, not covered by bone or skin (Stumpf et al, 1990; Tasker et al, 2013). A baby born with anencephaly is unconscious and will usually demise shortly after birth. Although some individuals with anencephaly may be born with rudimentary brain stem, the lack of a functioning cerebrum permanently rules out the possibility of ever gaining consciousness. Reflex actions, such as breathing and response to sound or touch, may occur (Rodeck and Whittle, 2009).

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