Incidence:
A specific pattern of malformation identified as fetal alcohol syndrome has been documented, and major and minor components of the syndrome are expressed in 1–2 infants/1,000 live births.
Both moderate and high levels of alcohol intake during early pregnancy may result in alterations in growth and morphogenesis of the fetus; the greater the intake, the more severe the signs. Infants born to heavy drinkers have twice the risk of abnormality as those born to moderate drinkers; 32% of infants born to heavy drinkers had congenital anomalies as compared with 9% in the abstinent and 14% in the moderate group. Additional maternal risk factors associated with fetal alcohol syndrome are advanced maternal age, low socioeconomic status, poor psychologic indicators, and binge drinking.
Clinical Features:
Characteristics of fetal alcohol syndrome include
(1) prenatal onset and persistence of growth deficiency for length, weight, and head circumference;
(2) facial abnormalities, including short palpebral fissures, epicanthal folds, maxillary hypoplasia, micrognathia, smooth philtrum, and a thin, smooth upper lip ;
(3) cardiac defects, primarily septal defects;
(4) minor joint and limb abnormalities, including some restriction of movement and altered palmar crease patterns; and
(5) delayed development and mental deficiency varying from borderline to severe.
Fetal alcohol syndrome is a common identifiable cause of mental retardation. The severity of dysmorphogenesis may range from severely affected infants with full manifestations of fetal alcohol syndrome to those mildly affected with only a few manifestations.
Cause of the Effects:
The detrimental effects may be due to the alcohol itself or to 1 of its breakdown products. Some evidence suggests that alcohol may impair placental transfer of essential amino acids and zinc, both necessary for protein synthesis, which may account for the intrauterine growth restriction.
Treatment:
Treatment of these infants is difficult because no specific therapy exists. These infants may remain hypotonic and tremulous despite sedation, and the prognosis is poor. Counseling with regard to recurrence is important.
Prevention:
Prevention is achieved by eliminating alcohol intake after conception
Fetal alcohol syndrome is a common identifiable cause of mental retardation. The severity of dysmorphogenesis may range from severely affected infants with full manifestations of fetal alcohol syndrome to those mildly affected with only a few manifestations.
Cause of the Effects:
The detrimental effects may be due to the alcohol itself or to 1 of its breakdown products. Some evidence suggests that alcohol may impair placental transfer of essential amino acids and zinc, both necessary for protein synthesis, which may account for the intrauterine growth restriction.
Treatment:
Treatment of these infants is difficult because no specific therapy exists. These infants may remain hypotonic and tremulous despite sedation, and the prognosis is poor. Counseling with regard to recurrence is important.
Prevention:
Prevention is achieved by eliminating alcohol intake after conception
No comments:
Post a Comment