Teratogens Flashcards
What is the effect of ACE inhibitors?
Renal damage
What is the effect of Alkylating agents?
Absence of digits, multiple anomalies
What is the effect of Aminoglycosides?
CN VIII toxicity
What is the effect of carbamazepine?
facial dysmorphism, developmental delay, neural tube defects, phalanx/fingernail hypoplasia
What is the effect of DES?
Vaginal clear cell adenocarcinoma, mullerian abnormalities
What is the effect of folate antagonists?
Neural tube defects
What is the effect of isoretinoin?
Multiple severe birth defects: contraception mandatory
What is the effect of lithium?
Ebstein anomaly
What is the Ebstein anomaly?
Atrialized right ventricle (lithium)
What is the effect of methimazole?
aplasia cutis congenita
What is aplasia cutis congenita?
Characterized by the absence of a portion of skin in a localized or widespread area at birth - most common on scalp. Caused by methimazole (among other causes)
What is the effect of phenytoin?
Fetal hydantoin syndrome: cleft palate, cardiac defects, phalanx/fingernail hypoplasia
What is the effect of tetracyclines?
Discolored teeth
What is the effect of thalidomide?
Limb defects (phocomelia, micromelia; flipper limbs)
What is the effect of valproate?
Inhibition of maternal folate absorption; neural tube defects
What is the effect of warfarin?
Bone deformities, fetal hemorrhage, abortion, opthalmologic abnormalities
What is the effect of Etoh?
common cause of birth defects and intellectual disability: fetal alcohol syndrome
What is the effect of cocaine?
Abnormal fetal growth and fetal addiction, placental abruption
What is the effect of smoking (mechanisms for nicotine, CO)?
Low birth weight (leading cause in developed countries), preterm labor, placental problems, IUGR, ADHD
(nicotine –> vasoconstriction
CO –> impaired O2 deliver)
What is the effect of lack or excess of iodine?
Congenital goiter or hypthyroidism (cretinism)
What is the effect of maternal diabetes?
Caudal regression syndrome (anal atresia to sirenomelia)
Congenital heart defects
Neural tube defects
What is the effect of Vitamin A excess?
Extremely high risk for spontaneous abortions and birth defects (cleft palate, cardiac)
What is the effect of X-rays?
Microcephaly, intellectual disability
What is the leading cause of intellectual disability in the US?
Fetal alcohol syndrome
What facial abnormalities are classic for fetal alcohol syndrome?
Smooth philtrum, hypertelorism
What is the mechanism of fetal alcohol syndrome defects?
Failure of cell migration
What are the most severe manifestations of fetal alcohol syndrome?
limb dislocation, heart-lung fistulas, holoprosencephaly
