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Table 3. Contra-indications for usage of dental contraceptives in Down problem.

Medroxyprogesterone (Depo-Provera) and Norplant (levonorgestrel implant) are often utilized depot kinds of contraception. In one single research, 50% of females getting Depo-Provera had been amenorrheic; this treatment may significantly simplify hygiene that is menstrualLaros, 1993). One 12 months of quarterly Depo-Provera injections costs approximately $200 (Laros, 1993). Norplant is just a progestin-impregnated silastic implant that is frequently inserted into top arm subcutaneous muscle. It is almost always effective for 5 years but can be eliminated sooner (Laros, 1993). Reports of problems needing treatment – including irregular genital bleeding – have actually dampened a few of the initial passion for Norplant. Price is projected between $300-$400 a(Laros, 1993) year.

Surgical contraceptive procedures consist of laparoscopic tubal ligation and total hysterectomy that is abdominal. Both procedures need informed permission and participation associated with the client and parent. A helpful guide regarding sterilization problems appears when you look at the 1988 book by the American Academy of Obstetrics and Gynecology on Ethics. The entire process of receiving a sterilization procedure may be emotionally draining and financially problematic for moms and dads (Van Dyke et al, 1995).

Std. Constant and correct usage of barrier techniques such as for instance condoms could be perhaps perhaps not practical within the Down problem population (Elkins, l990).

You will need to understand that the condom may be the just contraceptive method available which also helps in avoiding the transmission of condition. Those with Down problem could be at increased risk for std (STD). Transmission dangers for many STDs are outlined in Table 4. A 50-90% transmission chance of gonorrhea happens to be documented (rock, 1994). While no reports calculate the incidence of HIV disease in Down problem, HIV was reported when you look at the population that is mentally disabledKastner et al, 1989). Plainly, other intimately transmitted conditions including syphilis, chlamydia, herpes simplex, venereal warts, and hepatitis B are possible issues when you look at the intimately active person. In a nationwide research by Marchetti et al (1990), an overall total of 45 developmentally disabled individuals in 11 states had been told they have HIV disease (Marchetti et al, 1990). Danger facets associated with HIV disease in Down syndrome are the same as those in the basic populace and include heterosexual task, homosexual activity, IV substance abuse, and contaminated blood transfusions (Simonds and Rogers, 1992).

Dining Table 4. STD transmission danger per coital episode.


Somewhat impaired fertility of both sexes is clear within the Down problem populace (Rogers and Coleman, 1992). While men have traditionally been thought to be sterile, Sheridan states one instance of the cytogenetically normal male infant that had been fathered by a guy with Down problem (Sheridan et al, 1980). Females have actually weakened but still significant fertility: a quantity of reviews document ladies with Down syndrome holding pregnancy to term and delivering babies with and without Down syndrome (Bovicelli et al, 1982; Rani et al, 1990). Infants born to moms with Down syndrome have reached increased risk for untimely low and delivery birth fat (Bovicelli et al, 1982). Pregnancy outcomes obtained from the research of moms with Down problem are exhibited in dining dining Table 5. Whether a female with Down problem comprises a top danger pregnancy depends mostly on intellectual degree and status that is medical. Clearly, the current presence of maternal cardiac, thyroid, or hepatic illness, along with seizure disorder, complicates a maternity. The high incidence of congenital cardiovascular disease in almost any offspring with Down syndrome plays a role in pregnancy danger, including stillbirth and neonatal death (Gordon, 1990). Offspring without Down problem have actually a better than typical number of congenital anomalies (Bovicelli et al 1982) (see Table 5).

Dining Table 5. Reported link between maternity in Down problem


Just information that is scant available regarding the parenting abilities of individuals with Down problem (Van Dyke et al, 1995). The matter of parenting by way of a mentally disabled person is a controversial one. Some specialists keep that kids of mildly retarded partners are probably no worse off than young ones of people that are “classified as culturally deprived” (Nigro, 1975). Other writers opine that mentally parents that are disabled become more expected to neglect kids through functions of omission but that purposeful punishment can be infrequent, particularly in the setting of sufficient societal and household aids (Tymchuk, 1992).


In summary, sex is definitely an aspect that is intrinsic of development. Those with Down syndrome need individualized instruction and training to build up appropriate sociosexual habits.

While people with Down problem have actually unique and quite often complex medical requirements, they nevertheless need routine reproductive wellness services suitable for the typical populace including urological look after males, gynecological look after females, and preventive medical solutions. Education and guidance to avoid pregnancy that is unplanned punishment, and std should really be area of the routine health care and training for people with Down problem. All people with Down problem have actually the right to produce and show sex in a emotionally satisfying and socially appropriate way. It is the duty of care providers to facilitate communication, research, and help services to achieve this objective.