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Foetal alcohol syndrome (Epidemiology (Foetal alcohol syndrome 1:200, No…
Foetal alcohol
syndrome
Definition
Alcohol abuse
Use of alcohol in pregnancy that causes
mental, physical, or social harm to the individual
Foetal alcohol syndrome
Rare disorder of children
born to women who abuse alcohol
Pathophysiology
Mother (alcohol abuse)
GI disorders: liver disease, gastritis, peptic ulcers, varices, pancreatitis
Neurological disorders: peripheral neuropathy, epilepsy, cerebellar degeneration
Cardiovascular disorders: HTN, stroke
Foetus (foetal alcohol syndrome)
Pre- and postnatal retardation
Developmental delay
Craniofacial dysmorphism
Low IQ
Epidemiology
Foetal alcohol syndrome 1:200
No safe limit for alcohol
(recommend 1U/d)
Drink >18U/d 1/3 chance of
foetal alcohol syndrome
Clinical
presentation
General
IUGR
Short stature
Developmental delay
Gait abnormalities
Cardiac abnormalities
Facial features
Microcephaly
Microopthalmia (small eyes)
Short palpebral fissure
Short nasal bridge
Thin upper lip
Smooth, short philtrum
Cleft palate
Maxillary hypoplasia
Prevention
Pre-pregnancy counselling
Risks and encouraging reduced intake
Antenatal attendance
Support groups e.g. AA, social services
Domestic abuse screening
Diagnosis
Examination
Neonatal exam
Stigmata of FAS
Abdominal exam
SFH small for age
Signs of liver disease
Investigations
Bloods
FBC, U+E, LFTs, clotting,
glucose, lipids, toxicology, alcohol
USS
IUGR, cardiac abnormalities,
microcephaly, cleft lip/palate
History
POH
Gravity/parity, delivery,
complications
PGH
Menses, contraception,
STIs, smears
Current pregnancy
Gestation, bloods, scans,
complications, movements
PMH
Substance misuse, psychatric disorder,
medical conditions, previous surgeries
PC/HPC
Complications of alcohol
DH
Current meds
allergies
SH
Alcohol, smoking, drugs,
social support, domestic violence
Management
Conservative
MDT management (paeds, social services, alcohol support)
Serial USS (growth), detailed anomaly scan
Child protection conference
