FOETAL ALCOHOL SYNDROME (FAS)
F |
oetal Alcohol Syndrome, a congenital abnormality or
disorder caused by consumption of alcohol by the mother during pregnancy, which
includes mental retardation, growth retardation and retardation of growth of
the skull and facial bones.
No amount of alcohol is safe in pregnancy and thus it
is not fit to drink alcohol.
Occurs in all races and ethnicity. Ranges from 1in
1000 to less than 1 in 10,000 live births. Estimated 1-2 cases per 1000 live
births in the United States.
Pathophysiology – Alcohol
crosses placenta and reaches the foetus. Foetal liver does not have adequate
Alcohol Dehydrogenase enzyme (ALDH) and other anti-oxidants such as glutathione.
Amniotic fluid acts as a reservoir for the alcohol, prolonging the foetal
exposure. Aldehyde (a metabolite of alcohol) inhibits cellular migration and
inhibits DNA and protein synthesis. Aldehyde modify the metabolism of fats and
carbohydrates. They reduce the amount of amino acids, folic acids,
carbohydrates, proteins that reach the foetus and this affect its development.
Signs and Symptoms –
1. Growth
retardation.
2. Smooth
philtrum
3. Thin
upper lip
4. Small
eyes
5. Short
upturned nose
6. Flattened
cheeks
7. Small
jaw (maxilla and mandibles)
8. Microcephaly
9. Mental
retardation
10. Hyperactivity
11. Impaired language development
12. Seizures
13. Delayed development of gross motor skills and
fine motor skills.
14. Heart murmurs
15. ASD, VSD (Atrial Septal Defects, Ventricular
Septal Defects)
16. Joint Abnormalities, Small distal phalanges,
small fifth fingernail.
17. Strabismus, optic nerve hypoplasia
18. Horseshoe shaped kidney, aplastic or
dysplastic kidney.
Diagnostic criteria’s –
1.
Facial features
2.
CNS underdevelopment
3.
Prenatal alcohol exposure
Treatment –
1. Psychoactive
drugs
2. Behavioural
intervention
3. Do
not drink alcohol during pregnancy and after pregnancy.
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