Assignment: Sandwich Generation

Describe the Sandwich Generation.  What are the advantages and disadvantages to all three parties (children, middle adult manager, elderly adult)?  Who is most likely to be caught in the middle of the sandwich?  View the YouTube videos below for guidance.

• https://www.youtube.com/watch?v=YhXrHD7qWDk
• https://www.bls.gov/opub/mlr/2006/09/

  Amniocentesis Between the 15th and 18th weeks of pregnancy, amniocentesis may be performed. In this procedure, a sample of amniotic fluid is withdrawn by syringe and tested for chromosomal or metabolic disorders (Ekblad & others, 2015; Lehmann, 2016). The later in the pregnancy amniocentesis is performed, the better its diagnostic potential. However, the earlier it is performed, the more useful it is in deciding how to handle a pregnancy when the fetus is found to have a disorder. It may take two weeks for enough cells to grow so that amniocentesis test results can be obtained. Amniocentesis brings a small risk of miscarriage: about 1 woman in every 200 to 300 miscarries after amniocentesis.

  Maternal Blood Screening During the 16th to 18th weeks of pregnancy, maternal blood screening may be performed. Maternal blood screening identifies pregnancies that have an elevated risk for birth defects such as spina bifida and Down syndrome (Charkiewicz & others, 2016; Cuckle & Maymon, 2016), as well as congenital heart disease risk for children (Sun & others, 2016). The current blood test is called the triple screen because it measures three substances in the mother’s blood. After an abnormal triple screen result, the next step is usually an ultrasound examination. If an ultrasound does not explain the abnormal triple screen results, amniocentesis typically is used.

  Fetal MRI The development of brain-imaging techniques has led to increasing use of fetal MRI to diagnose fetal malformations (Gat & others, 2016; Sanz-Cortes & others, 2015; You & others, 2016) (see Figure 10). MRI, which stands for magnetic resonance imaging, uses a powerful magnet and radio images to generate detailed images of the body’s organs and structures. Currently, high-quality ultrasound is still the first choice in fetal screening, but fetal MRI can provide more detailed images than ultrasound (Wataganara & others, 2016). In many instances, ultrasound will indicate a possible abnormality and fetal MRI will then be used to obtain a clearer, more detailed image Page 55 (Milani & others, 2015; Tee & others, 2016). Among the fetal

  malformations that fetal MRI may be able to detect better than ultrasound sonography are certain abnormalities of the central nervous system, chest, gastrointestinal tract, genital/urinary organs, and placenta (Malinger & Lerman-Sagie, 2015). In a recent research review, it was concluded that fetal MRI often does not provide good results in the first trimester of pregnancy because of small fetal structures and movement artifacts (Wataganara & others, 2016). Also, in this review, it was argued that fetal MRI can be especially beneficial in assessing central nervous system abnormalities in the third trimester of pregnancy.

  https://html1-cluster-e.mheducation.com/smartbook2/data/151062/highlighted_epubmhe/OPS/s9ml/chapter02/ch02_reader_04.xhtml#data-uuid-be487812a5e24ad7afceabc74958e6bb

  Figure 10 A Fetal MRI

  Increasingly, MRI is being used to diagnose fetal malformations.© Du Cane Medical Imaging Ltd/Science Source

  Fetal Sex Determination Chorionic villus sampling has often been used to determine the sex of the fetus at some point between 11 and 13 weeks of gestation. Also, in a recent study, ultrasound accurately identified the sex of the fetus between 11 and 13 weeks of gestation (Manzanares & others, 2016). Recently, though, some noninvasive techniques, such as

  cell-free DNA analysis in blood plasma, have been able to detect the sex of the fetus at an earlier point (Breveglieri & others, 2016; Koumbaris & others, 2016; Moise & others, 2013). A meta-analysis of studies confirmed that a baby’s sex can be detected as early as 7 weeks into pregnancy (Devaney & others, 2011). Being able to detect an offspring’s sex as well as the presence of various diseases and defects at such an early stage raises ethical concerns about couples’ motivation to terminate a pregnancy (Browne, 2016; Lewis & others, 2012).

  Infertility and Reproductive Technology Recent advances in biological knowledge have also opened up many choices for infertile people (Asero & others, 2014). Approximately 10 to 15 percent of couples in the United States experience infertility, which is defined as the inability to conceive a child after 12 months of regular intercourse without contraception. The cause of infertility can rest with either the woman or the man, or both (Brazdova & others, 2016; Zhou & others, 2016). The woman may not be ovulating (releasing eggs to be fertilized); she may be producing abnormal ova; her fallopian tubes (by which ova normally reach the womb) may be blocked; or she may have a condition that prevents implantation of the embryo into the uterus. The man may produce too few sperm; the sperm may lack motility (the ability to move adequately); or he may have a blocked passageway (Takasaki & others, 2014).