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Fetal Alcohol Syndrome

What Is Fetal Alcohol Syndrome?
1) When a pregnant person drinks alcohol, some of that alcohol easily passes across the placenta to the fetus.
2) People with this condition may have problems with their vision, hearing, memory, attention span, and abilities to learn and communicate.
3) You can prevent fetal alcohol syndrome by avoiding alcohol during pregnancy.

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Fetal Alcohol Syndrome

  1. 1. TOPIC DISCUSSION Presenter Tejas Shah Chair Dr. Dweep Chand Singh FETAL ALCOHOL SYNDROME ALCOHOL AS A TERATOGEN
  2. 2. FETAL ALCOHOL SPECTURM DISORDERS 1PART
  3. 3. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FETAL ALCOHOL SPECTURM DISORDERS  FETAL ALCOHOL SPECTRUM DISORDERS (FASDS) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy.  FASD is the umbrella term for a range of disorders.  These disorders can be mild or severe and can cause physical and mental birth defects.
  4. 4. FAS ARBDs Full-blown fetal alcohol syndrome (FAS) represents only the “tip of the iceberg” relative to alcohol-related birth defects (ARBDs).
  5. 5. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FETAL ALCOHOL SPECTURM DISORDERS TYPES OF FASD INCLUDE  Alcohol-Related Birth Defects (ARBD)  Alcohol-Related Neurodevelopment Disorder (ARND)  Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure  Fetal Alcohol Effects (FAE)  Fetal Alcohol Syndrome (FAS)
  6. 6. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FETAL ALCOHOL SPECTURM DISORDERS ALCOHOL-RELATED BIRTH DEFECTS (ARBD): People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these. ALCOHOL-RELATED NEURODEVELOPMENTAL DISORDER (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control.
  7. 7. FETAL ALCOHOL SYNDROME 2PART
  8. 8. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FETAL ALCOHOL SYNDROME (FAS)  FAS can be defined as non-genetic congenital disease, abnormality or condition.  FAS represents the severe end of the FASD.  Fetal death is the most extreme outcome from drinking alcohol during pregnancy.  People with FAS might have abnormal facial features, growth problems, and central nervous system (CNS) problems.  People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing.  This is one of the major causes for mental retardation.
  9. 9. EPIDEMIOLOGY 3PART
  10. 10. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) 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
  11. 11. MECHANISM 4PART
  12. 12.  Mothers who drink alcohol expose fetus to alcohol in utero.  Alcohol in a pregnant woman's bloodstream circulates to the fetus by crossing the placenta.  The alcohol inhibits intrauterine growth and postnatal development.  There, the alcohol crosses the blood- brain barrier and interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development in the brain, heart and other body organs.
  13. 13. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) PREGNANCY TRIMESTERS ALCOHOL EXPOSURE DURING THE PREGNANCY TRIMESTERS  First: During the first trimester, alcohol interferes with the migration and organization of brain cells and the formation of the CNS.  Second: Heavy drinking during the second trimester, particularly from the 10th to 20th week after conception, seems to cause more clinical features of FAS than at other times during pregnancy.  Third: During the third trimester, the hippocampus is greatly affected, which leads to problems with encoding visual and auditory information (reading and math) and the inability to form or retain new memories.
  14. 14. MIDLINE STRUCTURES OF THE FACE AND BRAIN ARE DEFICIENT IN ALCOHOL- EXPOSED MOUSE EMBRYOS AND IN INDIVIDUALS WITH FAS THE FACE OF A CHILD WITH FULL-BLOWN FAS HAS FEATURES THAT CAN BE CAUSED BY DAMAGE TO MIDLINE STUCTURES. EYE EYE A C B D MOUTH MOUTH NOSTRILS NOSTRILS
  15. 15. EFFECTS OF FETAL ALCOHOL SYNDROME 5PART
  16. 16. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) EFFECTS OF FETAL ALCOHOL SYNDROME BIRTH DEFECTS  Leading cause of mental retardation  Multiple Organ Dysfunction  Intra and postnatal grow defects  Lower Intelligence  Dysfunction in central nervous system which can lead to learning disability  Cranial and Facial Dysmorphology (Eustace et. al., 2003)
  17. 17. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) EFFECTS OF FETAL ALCOHOL SYNDROME  Inattention  Inability to foresee consequences  Inability to learn from previous experience  Inappropriate Behaviour  Lack of Organization  Learning Difficulties  Poor Abstract Thinking  Poor Adaptability  Poor Impulse Control  Poor Judgment  Speech Problems  Hyperactivity COMMON COGNITIVE AND BEHAVIORAL PROBLEMS (Eustace et. al., 2003)
  18. 18. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) EFFECTS OF FETAL ALCOHOL SYNDROME  Mental Health Problems 90%  Dependent Living 80%  Employment Problems 80%  Disruptive School Experience 60%  Trouble with the Law 60%  Confinement 50%  Inappropriate Sexual Behavior 50%  Alcohol or Drug Problems 30% SECONDARY DISABILITIES (Koren et al., 2003)
  19. 19. SYMPTOMS AND FEATURES 6PART
  20. 20. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) SYMPTOMS AND FEATURES GROWTH RETARDATION  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
  21. 21. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) SYMPTOMS AND FEATURES FACIAL FEATURES  Eyes: small, slant downward, drooping eyelid, wide-set  Ears: large, low set (below eyes), posterior rotation (toward back of head), poorly formed concha (hollow of external ear)  Nose: upturned, shortened, hypoplasia of nasal bridge  Mouth: wide, thin upper lip, cleft palate, cleft lip, poorly formed teeth (Abel, 1984)
  22. 22. FACIAL FEATURES NORMAL FEATURES ABNORMAL FEATURES
  23. 23. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) SYMPTOMS AND FEATURES OTHER SIGNS  Cardiac  Heart murmur; usually disappears by one year of age  Ventricular Septal Defect (VSD)  Atrial Septal Defect (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  Low birth weight
  24. 24. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) SYMPTOMS AND FEATURES ABNORMAL ORGAN DEVELOPMENT People diagnosed with FAS may have abnormal organ development in the…. Heart, kidneys, genitals, respiratory system, liver, limb/joint and muscular abnormalities (Abel, 1984)
  25. 25. FETAL ALCOHOL SYNDROME DIAGNOSIS CRITERIA 7PART
  26. 26. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) DIAGNOSIS CRITERIA Q86 Congenital malformation syndromes due to known exogenous causes, not elsewhere classified  Q86.0 Fetal alcohol syndrome (dysmorphic) MUST MEET 3 CRITERIA TO BE DIAGNOSED WITH FAS 1) Prenatal or postnatal growth retardation (body weight, length, or head circumference) 2) Characteristic facial anomalies (at least 2 or 3)  a. Microcephaly (below 3rd percentile)  b. Microphthalmia or short palpebral fissures  c. Underdeveloped philtrum, thin upper lip, and maxillary hypoplasia 3) Central nervous system dysfunction (neurological abnormality, mental deficiency, developmental delay. (Abel 1984)
  27. 27. TREATMENT OPTIONS 8PART
  28. 28. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) TREATMENT OPTIONS  There's no cure or specific treatment  The physical defects and mental deficiencies typically persist for a lifetime  Heart abnormalities may require surgery  Learning problems may be helped by special services in school  Parents often benefit from counselling to help the family with a child's behavioural problem
  29. 29. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) TREATMENT OPTIONS  FAS Children do learn, but all learn differently, “find what works best and stick to it!”  Create a friendly and structured home environment that is familiar. . .  Creating routines/schedules serves as anchors overtime for children with FAS/FAE  Limit changes in their routine/schedules “less is better!” To avoid overwhelming REMEMBER, “STRATEGIES NOT SOLLUTIONS!”
  30. 30. SUMMARY 9PART
  31. 31. MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) SUMMARY  When a pregnant person drinks alcohol, some of that alcohol easily passes across the placenta to the fetus.  People with this condition may have problems with their vision, hearing, memory, attention span, and abilities to learn and communicate.  You can prevent fetal alcohol syndrome by avoiding alcohol during pregnancy.
  32. 32. THANK YOU FOR LISTENING
  33. 33. REFERENCES  Emory University (n.d.). Maternal Substance Abuse and Child Development. Retrieved December 28, 2016 from http://www.psychiatry.emory.edu/ PROGRAMS/GADrug/fasqa.htm#does  Graefe, Sara. (2004). (Ed.). Living with FASD: A Guide For Parents.  British Columbia: Special Needs Adoptive Parents. Groundwork Press. Retrieved December 28, 2016 from website: http://www.faslink.org/strategies_not_solutions.pdf  Kellerman, Teresa (2005). Symptoms of Fetal Alcohol Spectrum Disorders. Retrieved December 28, 2016 from http://www.come-over.to/FAS/faschar.htm  Kellerman, Teresa (2008). Prenatal Alcohol Exposure and the Brain. Retrieved December 28, 2016 from http://www.come-over.to/FAS/FASbrain.htm  Kock, Gregory C. &Kupesky, Regina H. (2002).  Parenting the Hurt Child: Helping Adoptive Families Heal and Grow. Pinon Press. Retrieved December 28, 2016 from website: http://www.faslink.org/strategies_not_solutions.pdf

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