David Yabrifa

INTRODUCTION FAS can be defined as congenital disease, abnormality

or condition caused by consumption of alcohol by mother during pregnancy, characterised by retardation of mental development and of physical growth particularly of skull and face of the infant.

Like any syndrome FAS is a group of signs and symptoms that appear together to indicate the condition.

No amount of alcohol consumption is safe during pregnancy.

EPIDEMIOLOGY Estimated 1-2 cases per 1000 live births in the United

States.

Ranges from 1 in 1000 to less than 1 in 10,000 live births internationally.

Occurs in all race and ethnicity

4-5% of all children in the normal first grade in school

PATHOPHYSIOLOGY Alcohol crosses the placenta and rapidly reaches the fetus Fetus liver does not have significant alcoholdehydrogenase(ADH),

ALDH and other antioxidants like glutathion Also amniotic acts as reservoir for alcohol, prolonging fetal

exposure

Acetaldehyde( metabolite of ethanol) disrupt cellular differentiation and growth, disrupting DNA and protein synthesis and inhibits cell migration

Acetaldehyde and ethanol modify metabolism of carbohydrate, protein and fats

They both also decrease the transfer of amino acids, glucose, folic acid, zinc and other nutrients across the placenta barrier which affects fetal growth.

SYMPTOMS Growth Retardation

Facial Features

Smooth philtrum

Thin upper lip (thin vermilion)

Small eyes

Short upturned nose

Flattened cheeks

Small jaw ( maxillae or mandible)

Facial Features

NORMAL FEATURES ABNORM FEATURES

Facial FeaturesNORMAL FEATURES ABNORMAL FEATURES

SYMPTOMS Central nervous system features

Microcephaly

Mental retardation

Hyperactivity

Delayed development of gross motor skills like rolling over, sitting up, crawling and walking

Impaired language development

Delayed in development of fine motor skills such as grasping objects with the thumb and index fingers and transfer objects from one hand to the other.

Seizures

OTHER SIGNS Cardiac

• Heart murmur; usually disappears by one year of age

• VSD

• ASD

Skeletal: Joint abnormalities, altered palmer crease pattern, small distal phalanges and small fifth fingernail.

Renal: Horseshoe, aplastic, dysplastic or hypoplastic kidney.

Ocular: Strabismus, optic nerve hypoplasia

DIAGNOSIS

The diagnostic criteria includes;

Growth deficiency

FAS facial features

Central nervous system damage

Prenatal alcohol exposure

TREATMENTMedical intervention

This involves use of psychoactive drugs

Behavioral intervention

PREVENTIONDON’T TRY THIS