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Teratology
Known Teratogens
Question | Answer |
---|---|
Chemotherapeutic agents malformations | malformations, IUGR, pancytopenia, CNS damage, cardiomyopathy, pregnancy loss and prematurity |
Types of chemotherapeutic agents | 1. Aminopterin and methotrexate |
Patterns of malformations w. aminopterin and methotrexate | 1. Pre and post natal growth deficiency 2. Mild MR 3. Craniofacial anomalies 4. Limb abnormalities |
Critical period for chemotherapeutic agents | 8-10 weeks gestation |
Antihypertensives- worst | ACE inhibitors |
ACE inhibitors heart malformations | PDA (along with IUGR, hypocalvaria, and renal tubular dysplasia) |
ACE inhibitors critical period | second and third trimester |
Anticonvulsants potential risks: | Malformations, OB complications, hemorrgage and other neonatal problems, developmental delays, behavioral problems |
Anticonvulsant embryopathy | Broad depressed nasal bridge, short nose with anteverted nares, long philtrum, maxillary hypoplasia, fingernail hypoplasia |
Anticonvulsants and meningomyelocele: | Valproic acid, carbamazepine |
Anticonvulsants and oral clefts | Phenobarbitol, phenytoin and iamotrigine |
Anticonvulsants and CHDs | 1. Phenobarbitol, phenytoin and valproic acid |
Critical period for anticonvulsants... | None established |
Low risk anticonvulsants | Lactimal |
Risk of Maternal Epilepsy | Women with epilepsy have an increased risk for adverse pregnancy outcomes, even when they are not taking anticonvulsants... |
Androgenic hormones: types | DES, Fluconazole, Methimazole, Misoprostol, Penicillamine |
DES | adenocarcinoma (up to 20 weeks) |
Methimazole (hyperthyroidism) | aplasia cutis congenita of the scalp (critical period 1st trimester, usually 6 to 8 weeks) |
Misoprostol | limb reduction defects, CNS anomalies, hydrocephalus and encephelomalacia, arthrogryposis |
Retinoids (Vit A derivs) | Accutane/Isotretinoin, Streptomycin, Tetracycline, Thalidomide |
Warfarin... | stippled eipihyses |
Warfarin is an... | anticoagulant |
Warfarin pattern of malformations... | prenatal onset growth deficiency, mental deficiency, seizures, severe hypoplasia of the nose, epiphyseal stippling |
Drugs causing clefting | Thalidomide, Fluconazole (Androgenic hormone), Anticonvulsants, corticosteriods |