Teratology Presentations

Question 1

How can zika virus be transmitted?

Answer 1

Mosquito bites, pregnant person to fetus, sexual activity, blood transfusions

Question 2

What pregnancy complications are associated with zika?

Answer 2

Preterm birth, low birth weight/small for gestational age, increased risk of pregnancy loss or stillbirth

Question 3

What are the symptoms of congenital zika syndrome?

Answer 3

Microcephaly, brain anomalies/damage, eye abnormalities, hearing loss, seizures, problems with limb/joint movement, dysphagia, developmental delay

Question 4

When is the period of risk for birth defects due to zika?

Answer 4

the greatest period of risk is in 1st and 2nd trimesters but birth defects have been documented with exposure in the 3rd trimester

Question 5

What examinations/management are recommended for babies with congenital zika virus?

Answer 5

Head ultrasound and/or brain MRI, ophthalmology exam, auditory brainstem response (ABR) test, developmental screening

Question 6

What are pregnancy complications that can result from cocaine use?

Answer 6

Placental abruption, preeclampsia, prematurity, low birth weight, miscarriage or stillbirth, congenital malformations of the urinary tract

Question 7

What are post-natal complications that may arise from cocaine use?

Answer 7

Neonatal abstinence syndrome, characterized by tremors, irritability, sleep difficulties, and excessive crying
Long-term behavior problems, learning difficulties, ADHD, vision and hearing problems

Question 8

What are the timing considerations for cocaine use regarding pregnancy?

Answer 8

First trimester use associated with less sociability and more withdrawn behavior
Second trimester thought to be the most sensitive period due to disrupted cortical neurogenesis and NCC migration
Third trimester use correlates with the highest risk for NAS

Question 9

What are the consequences of exposure related to ACE Inhibitors?

Answer 9

anuria and oligohydramnios, growth restriction, hypocalvaria, renal failure or impaired renal function, pulmonary hypoplasia, neonatal hypotension, persistent patent ducturs arteriosus, premature birth

Question 10

When is the critical period of exposure for ACE inhibitors?

Answer 10

Second trimester

Question 11

How does stage of syphilis disease relate to transmission risk?

Answer 11

Greatest risk during primary and secondary infection

If latent, risk is greatest during first 4 years following infection

Question 12

What pregnancy complications may arise from untreated syphilis?

Answer 12

pregnancy loss, preterm or stillbirth, impaired fetal growth, or neonatal death

Question 13

What findings are associated with congenital syphilis in a fetus?

Answer 13

Hepatomegaly, placentomegaly, anemia, polyhydramnios, ascites/hydrops

Question 14

How is syphilis treated in pregnancy?

Answer 14

Penicillin, though this may lead to Jarsich-Herxeimer reaction which is characterized by acute fever with joint pain, headache, and possibility of preterm labor or fetal heart tracing abnormalities

Question 15

What are signs of congenital syphilis in a newborn?

Answer 15

Osteochondritis, Hutchinson’s teeth, interstitial keratitis, deafness, saddle nose, saber shins, seizures, intellectual disability

Question 16

What are pregnancy complications related to COVID-19?

Answer 16

Admission to ICU, requiring ventilation, death, preterm delivery, miscarriage/stillbirth, preeclampsia, gestational diabetes

Question 17

How is timing of exposure to COVID-19 relevant to consequences in pregnancy?

Answer 17

3rd trimester exposure was associated with higher frequency preterm birth and babies were more likely to be admitted to the NICU

Question 18

What symptoms are seen in fetal valproate syndrome?

Answer 18

Most commonly, neural tube defects and cardiac anomalies like spina bifida and CHD
cleft lip and palate
musculoskeletal anomalies like arachnodactyly, absence of the first rib, club foot, etc.
Distinctive facial features like epicanthal folds, small upturned nose
Decreased cognitive function, ADD, learning differences, autism