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Down Syndrome Prevention Achieves 90% Prenatal Detection

the only approach to preventing Down syndrome is through prenatal diagnosis
Professor Hsieh points out that the only approach to preventing Down syndrome is through prenatal diagnosis

Below, Prof. Fon-Hon Hsieh of the College of Medicine speaks about the success of Down Syndrome prevention in Taiwan during his 40-year career at NTU.

Not long ago, a McDonald's restaurant in Kaohsiung City refused to serve a 40-year-old female diner with Down syndrome, provoking popular outrage and drawing society's attention to the plight of people with Down syndrome and their families. Down syndrome has been among the main foci of my four-decade career at NTU, and NTU has served as the base from which I have achieved wide success in the prevention of Down syndrome in Taiwan.

Down syndrome is neither preventable by vaccine nor curable after birth, and the only approach to prevention was through a prenatal diagnosis of the amniotic fluid. The extraction of amniotic fluid requires the performance of amniocentesis, which means inserting a needle into the abdomen during the fourth or fifth month of pregnancy. More than thirty years ago, this procedure was widely unaccepted; therefore, the percentage of older pregnant women undergoing amniocentesis sat at 7.5% in 1988. With the advancement of medical technology, this figure climbed to 75% by 2000 and has already reached 90% in recent years.

Meanwhile, the introduction of more advanced amniotic fluid screening methods in recent years has boosted the Down syndrome detection rate from 70% to 80%. Also, a new non-invasive prenatal serum screening test provides 100% accuracy.

In Taiwan, neither of the two prenatal screening methods is fully covered by the National Health Insurance, therefore market mechanisms were adopted in order to induce doctors, testing clinics and testing agent suppliers to promote these important prenatal screening mechanisms. This market approach has facilitated the success of Down syndrome prevention, while saving the government money.

In 2012, prenatal screening discovered 309 cases of Down syndrome in Taiwan, while 39 babies were born with the disorder. This calculates into a prenatal detection rate of 90%.

Nonetheless, many people with Down syndrome in Taiwan have entered adulthood and middle age, creating increasing burdens for the parents who care for them. As Down syndrome is often accompanied by early dementia, caregivers face ever growing difficulties as they themselves get older. The recent incident at McDonald's highlights this problem, and while great efforts have been put into its prevention, we remain waiting for the government to place more emphasis and resources on the issue.

Read the original article in the June edition of NTU Highlights and other exciting articles HERE .

Chinese version