Teratogens and SGA Flashcards
What abnormalities occur in infants exposed to ACE inhibitors in utero?
Exposure to ACE inhibitors in the 2nd and 3rd trimesters increases the risk of renal dysgenesis, oligohydramnios, and skull ossification defects.
What is the most common overall cause of intellectual disability?
Fetal alcohol syndrome
What complications are associated with the presence of maternal hypertension after the 20th week of gestation?
IUGR, placental insufficiency, and placental abruption or previa.
Define small for gestational age.
Infants who are SGA have birth weights <10th percentile for all fetuses at the same gestational age.
What are some of the (12) perinatal complications that an SGA infant can have?
Perinatal asphyxia, meconium aspiration, persistent pulmonary HTN, necrotizing enterocolitis, respiratory distress syndrome, intracranial hemorrhage, temperature instability, hypoglycemia, polycythemia/hyperviscosity, impaired immune function, impaired protein and lipid metabolism, neurodevelopmental abnormalities.
What abnormality are infants exposed to carbamazepine in utero at risk for?
When exposure occurs between 15 and 29 days after conception, there is an increased risk (<1%) for the development of spina bifida.
What syndrome is seen in infants who were exposed to phenytoin in the 1st trimester of pregnancy?
Fetal hydantoin syndrome (growth deficiency, developmental delays, craniofacial anomalies, and hypoplastic phalanges/nails).
What (6) congenital abnormalities would one expect in an infant exposed to retinoids in utero?
Microcephaly, facial nerve palsies, microtia and external auditory canal anomalies, cardiovascular defects, thymic hypoplasia, and GU anomalies.
Define inrauterine growth restriction.
IUGR refers to a condition in which a fetus is not able to achieve its genetically determined potential size. By definition, this excludes infants who are SGA but are not pathologically small.
How might an infant exposed to mercury in utero present clinically?
Mercury poisoning in the fetus can manifest as cerebral atrophy, seizures, and developmental delay.
What two congenital cardiac abnormalities can be seen as a result of Lithium use before 8 weeks of gestation?
Lithium use results in a <1% chance of Ebstein anomaly. Congenital heart block can also occur.
List three retinoids which should be avoided in pregnancy.
Isotretinoin, etretinate, and megadoses of Vitamin A (retinol). They are used to treat acne and psoriasis and women using these medications should be using reliable forms of birth control.
What is the definition of a low birthweight infant?
< 2,500 g
What are the risks to the fetus of exposure to valproic acid in utero?
Valproic acid use in the first 30 days after conception has a 2% risk of spina bifida. Use during the 1st trimester can result in craniofacial abnormalities and preaxial defects.
How might extensive maternal hyperthermia during pregnancy adversely affect the fetus?
Extensive hyperthermia for prolonged periods (hot tub users and high maternal fever) during days 14-30 postconception increases the risk of neural tube defects.
Lsit five congenital anomalies which may occur due to maternal infection with CMV during pregnancy.
Low birth weight, intellectual disability, microcephaly, periventricular calcifications, and hearing loss.
What is neonatal abstinence syndrome (NAS)?
NAS refers to the withdrawal symptoms in a neonate born to a mother who takes or abuses certain drugs, particularly opiates, during pregnancy. The central and autonomic nervous systems are especially vulnerable.
What are the different congenital anomalies caused by rubella? How are these dependent on the time of infection?
Infection up to 8 weeks gestation: deafness (85% affected). Infection from 9-12 weeks: cataracts (52% affected). Infection from 12-30 weeks: heart defects (16% affected).
