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Introduction One of the symptoms of fetal ethanol syndrome is one of the symptoms of fetal ethanol syndrome. Fetal alcoholic syndrome (FAS) refers to the mother's alcoholism during pregnancy, which causes the fetus to grow and develop in the uterus and after birth. The main clinical features of fetal alcohol syndrome are: low intelligence, special face and various deformities.

Cause

(1) Causes of the disease

Its occurrence may be related to alcohol directly affecting the intrauterine fetus. Studies have found that the hyperplasia of the placenta of a large number of alcohol-promoting mothers may affect the fetus indirectly, causing fetal dysplasia or deformity. In addition, fetal alcohol syndrome may also be related to the toxic effects of aldehyde, a metabolite of alcohol oxidation, on cells, leading to developmental disorders of fetal nerve cells.

(two) pathogenesis

Although this fetal syndrome is undoubtedly associated with severe alcohol abuse in the mother, it is not clear what mechanism the effects of alcohol are. In humans and animals alcohol can pass through the placenta, although the effects of toxic effects of acetaldehyde and smoking and nutrient deficiencies cannot be completely ruled out, and embryotoxicity and teratogenic effects in mice, rats, chickens, miniature pigs and beagle dogs. It has been suggested that blood containing alcohol through the placenta and elevated prostaglandins caused by alcohol is a mechanism for alcohol damage to embryo growth and development, but it has not been confirmed.

Clarren et al found a wide range of pial glial ectopic and obstructive hydrocephalus. Hydrocephalus can be secondary to the dense displacement of glial cells around the brainstem, as well as neuronal neuronal translocation and corpus callosum dysplasia. Peiffer et al. cited a variety of generalized malformations, including the same cerebellar ectopic, cerebral schizophrenia, corpus callosum dysplasia, and olfactory brain malformation as the Dandy-Walker syndrome.

A typical child with FAS is seen only in infants born to women who are extremely alcohol abused and who continue to drink alcohol throughout pregnancy (most have tremors and liver lesions). The limits of the degree of alcohol abuse in the mothers who develop FAS syndrome and the critical period of FAS during pregnancy remain unclear. It is estimated that the above various teratogenic effects occur in the embryonic phase, mostly within the first two months of embryonic development. Other non-teratogenic effects are associated with exposure to extra-high alcohol levels in pregnant embryos.

an examination

Related inspection

Blood routine

1. Special face and various deformities:

The affected fetus has a relatively short body length, with short eye cracks, obvious internal folds, strabismus, myopia, and ptosis; saddle nose and nostrils leaning forward or nose; the upper lip is thin, the person is rounded, too long or Absence; flat dysplasia in the middle of the face, posterior rotation or dysplasia of the ear, mandibular retraction (infancy), mandibular or maxillary protrusion (adult), cleft lip and cleft palate are more common than the general population. The palms present longitudinal palm prints, finger flexion deformities, and/or other joint movement limitations. There may also be cardiac malformations (generally ventricular septal defects) and abnormalities in the external genitalia. With the increase of age, there may be hydrocephalus caused by microcephaly or brain stem deformity, meningocele and lumbosacral lipoma. There are also reports of corpus callosum, olfactory brain, brain penetrating malformations, thalamic and hypothalamic dysplasia and sponge-like changes, as well as syringomyelia. Half of the children who passed the neonatal period did not reach the normal standard of weight, height and head circumference even if they had an ideal environment for growth.

2. Newborns often show sucking and sleep disorders:

Most children have irritability, hyperactivity, and tremors. These symptoms are similar to alcohol withdrawal syndrome except for persistence.

3. Children often have different levels of mental retardation:

The existing distraction, carelessness, hyperactivity and fine motor incompatibility are prominent symptoms of children in early childhood. This type of child can also often be diagnosed as attention deficit syndrome. 80% of children with fetal alcohol syndrome may have language barriers, mainly due to difficulty in making single-sounding words or whole sentences. The main reason is that the mother has a history of alcohol abuse during pregnancy, and the child has mental retardation and special face. Prenatal and postnatal developmental stagnation and other parts of the deformity can be confirmed. If the child has only partial manifestations of the syndrome, the mother is a serious drinker, the diagnosis is more difficult. The FAS syndrome, which is not fully developed, is called fetal alcohol, and its incidence is more difficult to determine.

Differential diagnosis

Note the differentiation from other hereditary diseases with facial deformities. A variety of head and face deformities are caused by abnormalities in the first and second thoracic ridges that form the facial bones and ears at 2 months of gestation. These malformations include cleft lip and palate: Treacher Collin (mandibular dysplasia), Goldenen (eye, ear, vertebral hypoplasia), Pierre Robin and Warardenbury syndrome; increased distance between organs, external and middle ear malformations. Most infants with head and face deformities have normal intelligence and development.

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