Fetal alcohol syndrome
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Transcript of Fetal alcohol syndrome
INTRODUCTION FAS can be defined as congenital disease, abnormality
or condition caused by consumption of alcohol by mother during pregnancy, characterised by retardation of mental development and of physical growth particularly of skull and face of the infant.
Like any syndrome FAS is a group of signs and symptoms that appear together to indicate the condition.
No amount of alcohol consumption is safe during pregnancy.
EPIDEMIOLOGY Estimated 1-2 cases per 1000 live births in the United
States.
Ranges from 1 in 1000 to less than 1 in 10,000 live births internationally.
Occurs in all race and ethnicity
4-5% of all children in the normal first grade in school
PATHOPHYSIOLOGY Alcohol crosses the placenta and rapidly reaches the fetus Fetus liver does not have significant alcoholdehydrogenase(ADH),
ALDH and other antioxidants like glutathion Also amniotic acts as reservoir for alcohol, prolonging fetal
exposure
Acetaldehyde( metabolite of ethanol) disrupt cellular differentiation and growth, disrupting DNA and protein synthesis and inhibits cell migration
Acetaldehyde and ethanol modify metabolism of carbohydrate, protein and fats
They both also decrease the transfer of amino acids, glucose, folic acid, zinc and other nutrients across the placenta barrier which affects fetal growth.
SYMPTOMS Growth Retardation
Facial Features
Smooth philtrum
Thin upper lip (thin vermilion)
Small eyes
Short upturned nose
Flattened cheeks
Small jaw ( maxillae or mandible)
SYMPTOMS Central nervous system features
Microcephaly
Mental retardation
Hyperactivity
Delayed development of gross motor skills like rolling over, sitting up, crawling and walking
Impaired language development
Delayed in development of fine motor skills such as grasping objects with the thumb and index fingers and transfer objects from one hand to the other.
Seizures
OTHER SIGNS Cardiac
• Heart murmur; usually disappears by one year of age
• VSD
• ASD
Skeletal: Joint abnormalities, altered palmer crease pattern, small distal phalanges and small fifth fingernail.
Renal: Horseshoe, aplastic, dysplastic or hypoplastic kidney.
Ocular: Strabismus, optic nerve hypoplasia
DIAGNOSIS
The diagnostic criteria includes;
Growth deficiency
FAS facial features
Central nervous system damage
Prenatal alcohol exposure