Q: I got married one and a half years ago. My wife is related to me before our marriage. My father-in-law is my mother's younger brother. The blood group of both me and my wife is O positive. My wife conceived 10 months ago. We have taken more than 5 scans for fertility growth. Our doctors told that the baby is normal and active. After 8 and a 1/2 months, me and my wife went to another doctor who took a scan because a large hydramnios was seen around the baby which indicated that the baby has some problems like cardiac, limb, or trisomy 18. My family doctor suggested that it is better to deliver the baby as soon as possible because the baby will live for a few weeks only. Even before I admitted my wife in the hospital, the membrane of my wife burst. The doctors made utmost effort to deliver the baby normally. But the baby had to be delivered through a caesarean. The baby struggled to breathe after delivery and expired after one hour. Are there any chances for us to get another baby? Will the baby be normal?

A:There is nothing to despair. It is not unusual for many malformations not to be detected in early pregnancy by ultrasound scans. It would have been better if the fetus would have been examined after delivery. Was any photograph or x-ray of the fetus taken. Is there a note of the obstetrician regarding anomalies seen in the fetus. The exact report of the ultrasound scan showing abnormalities will have to be seen before something definite regarding diagnosis of trisomy 18 can be accepted. Trisomy 18 has nothing to do with consanguinity. Its recurrence is not significant. But we will have to keep an open mind about the diagnosis of the fetus. It would be appropriate for the couple to seek advice at a Medical Genetics Centre. You can consult Dr. I.C. Verma at the Sir Ganga Ram Hospital or Dr. Shubha Phadke at SGPGI, Lucknow. It would be required to know about the medical history of the family in view of consanguinity and to evaluate the need for chromosomal study of the parents to exclude carrier state of some chromosomal rearrangement. Next pregnancy may also require monitoring.