2. 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.
3. 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
4. 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.
5. SYMPTOMS
Growth Retardation
Facial Features
Smooth philtrum
Thin upper lip (thin vermilion)
Small eyes
Short upturned nose
Flattened cheeks
Small jaw ( maxillae or mandible)
8. 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
9. 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
10. DIAGNOSIS
The diagnostic criteria includes;
Growth deficiency
FAS facial features
Central nervous system damage
Prenatal alcohol exposure