Teratogens Flashcards
Nose hypoplasia, long bone deformation
What exposure does this point to, and when was the exposure?
Warfarin (blood thinner)
8-11 weeks post LMP
What exposure overall has 2x the population risk of an abnormal outcome?
What is the risk?
Anti-epileptic drugs
6-15%
What antiepileptic drug has the highest risk of an adverse outcome?
Valproic acid (8-10%)
Lithium exposure during organogenesis in pregnancy can cause:
Ebstein’s anomaly (valvular dysfunction of the tricuspid valve (R)
other CHDs
miscarriage
What teratogen is known for causing bilateral limb defects when exposure occurs in the first trimester?
Thalidomide
vulnerable period for thalidomide
30-50d post LMP
What malformations are associated with earlier exposure to thalidomide?
anotia, thumb hypoplasia
What malformations are associated with middle exposure to thalidomide?
microtia, upper limb anomalies, lower limb anomalies
Likely cause of reproductive tract defects and uterine malformations in females
prenatal DES (diethylstilbesterol) exposure
Prenatal DES exposure results in an increased risk for
adenocarcinoma
breast cancer
infertility
What exposure would cause a fetus to present with caudal regression?
Uncontrolled maternal diabetes
Risks associated with Prozac exposure
heart defects
craniosynostosis
Risks associated with Paxil
anaencephaly
CHD
gastroschisis, omphalocele
Risks with valproic acid exposure
spina bifida (not anencephaly) CNS, skeletal, craniofacial malformations developmental delay, autism
Risks with accutane
pregnancy loss
major malformations
cognitive dysfunction
vulnerable period of accutane
1st trimester
Critical period for animicrobial drugs/antibiotics
all pregnancy and immediately after birth
Symptoms of tetracycline exposure
deposition in long bones
yellow discoloration of teeth
Phenotypic effects of fetal alcohol exposure
growth retardation microcephaly cognitive and behavioural dysfunction VSD vertebral defects CNS malformations hypoplastic nails
smooth philtrum
flat midface
epicanthal folds
thin upper lip
phenotypic effects of high maternal Phe
microcephaly
CHDs
growth retardation
DD
TORCH(Z) of teratogenic intrauterine infections
Toxoplasmosis Other (Syphilis, Varicella, Parvovirus) Rubella Cytomegalovirus Herpes simplex Zika virus
phenotypic effects of toxoplasmosis
hydrocephalus
intracranial calcification
chorioretinitis
pregnancy loss
(more severe with earlier exposure)
phenotypic effects of parvovirus exposure
hydrops abdominal swelling ventriculomegaly hypertrophic cardiomyopathy placentomeagaly
(ie. fluid accumulation + cardiomyopathy)
in children: bright red cheeks
phenotypic effects of rubella exposure
cardiac defects cataracts microcephaly deafness ID "blueberry muffin" rash
