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Overview

  • Week 1-3
    • "all-or-none": the embryo either dies or survives without any complications
  • Week 3-8 (Embryonic Period)
    • most vulnerable time period due to organogenesis
  • Week 8-38
    • growth and function of organ/embryo is affected
    • decreased susceptibility due to organs already formed
Teratogens
 
Examples
Effects on fetus
ACE inhibitors
  • Renal damage
    • renal dysplasia
Alcohol
  • Fetal Alcohol Syndrome
Alkylating agents
  • Absence of digits
  • Cleft palate
  • Renal agenesis
Aminoglycosides
  • CN VIII toxicity
Anticonvulsants
  • Cleft lip and palate
Cocaine
  • Abnormal fetal development
  • Fetal addiction
  • Low-birth weight
  • Placental abruption
Diethylstilbestrol (DES)
  • Vaginal clear cell adenocarcinoma
  • Other cervical, ovarian, and uterine abnormalities
Folate antagonists
  • Neural tube defects
    • myelomeningocele
Lithium
  • Ebstein's anomaly
    • atrialized right ventricle 
Maternal diabetes
  • Caudal regression syndrome 
    • sirenomelia
    • renal dysplasia or aplasia
    • imperforate anus
Phenytoin
  • Cleft lip and palate
  • Congenital heart defects
Potassium iodide
  • Congenital goiter or hypothyroidism
  • Cretinism
Nicotine
  • Premature delivery
  • Low birth weight
  • Intrauterine growth retardation
  • ADHD
Tetracyclines
  • Discolored/stained teeth
Thalidomide
  • Gastrointestinal atresia 
  • Absence or malformation of external ear
  • Phocomelia 
    • "seal" limbs
Valproate
  • Inhibits intestinal folate absorption leading to neural tube defects
  • Cleft lip
  • Renal defects
Vitamin A/isotretinoin
  • Spontaneous abortions
  • Cleft palate
  • Cardiac abormalities
  • Eye and external abnormalities
Warfarin
  • Bone deformities
    • femur, vertebral, and calcaneus show stippled appearance on X-ray
  • Fetal hemorrhage
  • Abortion
  • Spasticity and seizures
 
Fetal Alcohol Syndrome
  • Fetal alcohol syndrome (FAS)
    • pregnant mothers who consume alcohol increase their risk of delivering a child with FAS:
      • mental retardation
      • limb dislocation
      • cardiovascular defects such as ventricular septal defects
      • microcephaly
      • holoprosencephaly
      • facial abnormalities: hypertelorism, short palepebral fissures, long philtrum
      • heart and lung fistulas
    • alcohol is leading cause of mental retardation
 

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