Fetal Alcohol Syndrome

By:  Dr. Umesh N Jindal On:  August 31, 2016 8:49 AM
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Definition: Fetal alcohol syndrome refers to the signs and symptoms manifested in the fetus due to fetal injury resulting from alcohol consumption by the mother.

Cause:

Alcohol consumption by mother. Effects are related to:

  • Type of alcohol consumed.
  • Quantity of alcohol consumed.
  • Maternal age.
  • Trimester in which fetus is exposed.
  • Other drugs and environmental exposure.
  • Threshold dose for mother.
  • Pregnancy complications.
  • Binge drinking.
  • Threshold – 0.5 oz. of absolute alcohol per day is the threshold below which no alcohol related effects occur.

Prevalence:

Alcohol use during pregnancy varies but has been reported to be 1 to 2 percent. It is one of the most recognizable causes of mental retardation in United States.
Symptoms: Fetal alcohol syndrome cannot be diagnosed prenatally. The effects of alcohol appear to be biphasic as a linear dose response is observed only once a threshold of six drinks per occasion is met. Women ingesting eight or more drinks daily throughout pregnancy have a 30 to 50 % risk of having a child with all features of fetal alcohol syndrome.

Features include:

  • Growth restriction
  • Behavioral disturbance
  • Brain defects
  • Cardiac defects
  • Spinal defects
  • Craniofacial anomalies
  • Absent to hypoplastic philtrum
  • Broad upper lip
  • Flattened nasal bridge
  • Hypoplastic upper lip vermilion
  • Micrognathia
  • Microphthalmia
  • Short nose
  • Short palpebral tissues

Diagnosis:

  • History of alcohol consumption by mother.
  • Ultrasound may help in diagnosis of only some defects like cleft lip or cardiac defects.
  • The affected child typically has hyperreactivity and persistent irritability in early years followed by development delay, growth deficiency, a variable degree of mental retardation, hyperactivity, poor coordination and distinctive facial features.

Treatment:

  • Early cessation of alcohol consumption results in amelioration of some effects.
  • Prenatal exposure should also be avoided as it increases the risk of brain hemorrhage and white matter brain damage in preterm babies.