Exam 4 - Fetal Alcohol Spectrum Disorders Flashcards
Maternal and fetal risk factors for having alcohol spectrum disorders
- Advancing maternal age
- Increasing parity
- Poor maternal nutritional status
- Mothers of African American or Native American descent
- Binge drinking more harmful than having one drink/day
- Esp during early weeks of pregnancy when organogenesis occurs
Common effects of alcohol on the fetus
- IUGR
- Increased rates of malformation
- Chronic fetal hypoxia
What are the most severe effects of fetal alcohol syndrome (FAS) on the fetus?
- Birth defects
- Mental retardation
- Lifelong disabling behavorial problems
Clinical findings of children with FAS
- IUGR and postnatal growth restriction (fall off growth curves)
- CNS abnormalities
- Microcephaly
- Structural brain abnormalities
- Developmental delays
- Retardation
- Poor motor control
- Attention deficits
- Hyperactivity
- Muscle weakness
Phenotypic features (specific facial dysmorphology) in children with FAS
- Underdeveloped philtrum
- Thin upper lip
- Flat midface
- Short or upturned nose
- Low nasal bridge
- Ear anomalies (“railroad track” ears)
- Short palpebral fissure
- Ptosis
- Micrognathia
- Epicanthal folds
Diagnostic criteria for FAS
- Confirmed maternal alcohol exposure
- Characteristic pattern of facial anomalies
- Evidence of growth retardation
- Low birth weight, decelerating weight over time, low weight compared to height
- Evidence of CNS neurodevelopmental abnormalities
- ADHD, learning disabilities
Diagnostic criteria for partial FAS
- Confirmed maternal alcohol exposure
- Evidence of some of the characteristic patterns of facial anomalies
- Evidence of at least one of the following growth retardations
- Low birth weight
- Decelerating weight over time
- Disproportionately low weight to height
- Evidence of CNS neurodevelopmental abnormalities
- Complex pattern of behavorial or cognitive abnormalities
Diagnostic criteria for alcohol-related neurodevelopmental disorder
- Evidence of CNS neurodevelopmental abnormalities, and one of the following
- Decreased cranial size at birth (head circumference)
- Structural brain abnormalities
- Neurologic hard or soft signs
AND/OR
- Evidence of complex pattern of behavior or cognitive abnormalities that are inconsistent with developmental level
Alcohol related birth defects: cardiac
- ASD
- VSD
- Aberrant great vessels
- Tetralogy of fallot
Alcohol related birth defects: skeletal
- Hypoplastic nails
- Shortened fifth digit
- Radioulnar synostosis
- Flexion contractures
- Camptodactyly
- Clindodactyly
- Pectus excavatum and carinatum
- Klippel-Feil syndrome
- Hemivertebrae
- Scoliosis
Alcohol related birth defects: renal
- Ureteral duplications
- Horseshoe kidneys
- Aplastic, dysplastic, and hypoplastic kidneys
- Hydronephrosis
Alcohol related birth defects: ocular
- Strabismus
- Retinal vascular abnormalities
- Refractive problems secondary to small globes
Alcohol related birth defects: auditory
- Conductive hearing loss
- Neurosensory hearing loss
Fetal alcohol spectrum disorder differential diagnoses
- Williams syndrome
- Noonan syndrome
- Dubowitz syndrome
- Bloom syndrome
- Russell-Silver syndrome
- Fetal hydantoin syndrome
- Maternal PKU effects
- Fragile X syndrome (chromosomal)
- Turner syndrome (chromosomal)
What is the four-digit diagnostic code?
Tool used to assess risk for fetal alcohol spectrum disorder
- Growth deficiency
- Facial features
- CNS damage
- Prenatal alcohol exposure
