Teratogens & Exposures during Pregnancy Flashcards
ACE inhibitors
renal anomalies/potter sequence, IUGR, skull ossification defects, oligohydromas
Critical period: 2nd + 3rd trimester
Alcohol
learning and behavioral differences; ptosis; short palpebral fissures, smooth philtrum
Anti-convulsants
ONTDS, clefting, CHD, limbs, DD
i.e. Valporic acid has most significant impact
Maternal Diabetes
Caudal regression
Lithium
Ebstein anomaly
Maternal PKU
Pregnancy loss, Microcephaly, ID, heart defect
Mercury
Minimata disease (neurological disorder)
Radiation (>5 rads)
Fetal malignancy, miscarriage, IUGR, ID
SSRIs examples and fetal outcomes
medications to treat depression; Temporary neonatal jitteriness, irritability, respiratory distress
Thalidomide
limb reduction
Androgens and high doses of nor-progesterones
masculinization of external genitalia
Diethylstilbestrol
vaginal adenosis/adenocarcinoma; cervical erosions and ridges
Warfarin
Nasal Hypoplasia, stippled epiphyses, CNS defects
Hydantoin
Dysmorphic features, hypo plastic nails, growth-restriction, ID
Trimethadione
DD, dysmorphic facies
Methotrexate
pregnancy loss, hydrocephalus, low birth weight, dysmorphic features
Streptomycin
hearing loss
Tetracycline
stained teeth, enamel hypoplasia
Isotretinion / Accutane
Pregnancy loss, hydrocephalus, other CNS defects, small/absent thymus, microtia/anotia, conotruncal heart defects
Antithyroid Drugs
hypothyroidism, goiter
Penicillamine
cutis laxa
Carbamazepine
Neural tube defects
cocaine
pregnancy loss, placental abruption, growth restriction, microcephaly
Toxoplasmosis
hydrocephalus, blindness, ID
Varicella
Skin scarring, limb reduction defects, muscle atrophy, ventriculomegaly
Syphilis
snuffles, hutchinson teeth, saber shins, saddle nose
Cytomegalovirus
Growth restriction, ID, microcephaly, hearing loss, ocular anomalies
Herpes
no prenatal issues; exposed at birth can develop CNS and organ damage
Pre-gestation DM
Congenital heart defects, caudal deficiency, NTDs, limb defects, holoproscencephaly, pregnancy loss
Rubella
deafness, CHDs, CNS; blueberry muffin rash; salt and pepper retinopathy
later onset: DM, thyroid, panencephalitis
Toxoplasmosis (raw meat, soil, raw veggies, cat feces)
Hydrocephalus, HL, VL, intracranial classifications, seizures, DD
Hepatitis
can infect fetus; 70-90% will be chronic carriers w/ increased risks for HCC and cirrhosis
Parvovirus B19 (Fifth disease)
fetal hydrops, anemia
zika
10-15% w/ defects: microcephaly, lissencephaly, cerebral calcs, ventriculomegaly, eye anomalies, HL, CP, brainstem and cerebellar hypoplasia, growth restriction, dysphagia
West Nile virus
on study of 28 infected pregnancies only 1 w/ encephalopathy
When to consider TORCH screening ; sample types
IUGR, microcephaly, intracranial calcifications, hearing loss, seizures, and cataracts
infant blood, maternal blood, amnio sample
IgM antibodies present in TORCH screen indicates
recent infection, there is risk to baby
IgG antibodies present in TORCH screen indicates
past infection / vaccination (likely before pregnancy)
What infections can TORCH screen for
Toxoplasmosis
O- Syphilis, Parovirus, Varicella
R- Rubella
C- Cytomegalovirus
H - Herpes
