Cranio - 07 - Teratology

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Teratology

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study of the causes and patterns of congenital anomalies

malformations could be related to a structural / behavioral / functional problem

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Periods of development

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early development = first 2 weeks

embryonic period = weeks 3-8

fetal period = weeks 9-birth

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early development

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period of development during = first 2 weeks

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Embryonic period

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Period of development during week 3-8

this is when the basic structural organization of organ systems are being set up

Most sensitive period to teratogenic defects

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Fetal period

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Period of development during weeks 9-birth

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During what time are fetusus most sensitive to teratogenic defects

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Weeks 3-8 - Embryonic period

this is when the basic structural organization of organ systems are being set up

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what does susceptibility of the fetus depend on

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Genotype and exposure

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Malformation

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abnormal development early on during the embryonic period

characterized by something being missing / deficient from the very beginning

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Disruption

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morphological alterations of structure later in development during the fetal period, after the structure has already begun its formation

Due to exposure to a teratogen

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Amniotic Band Syndrome

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Disruption

Pieces of amniotic sac forms a thickened band structure that wraps around part of the fetus causing amputations in utero

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Deformation

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morphological alterations of a structure later in development (fetal period)

Due to physical trauma

removal of the mechanical force / pressure will allow continuation of normal development

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Clubbed fett

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Deformation

Due to physical trauma during fetal period

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Dysplasia

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non-specific abnormal organization of cells into tissues into organs

Due to environment

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Syndrome

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a homogenous complex of anomalies that ALWAYS occur together b/c they have a common genetic link

people suffering from a syndrome will have the same anomalies as each other

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Sequence

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may be characterized by the same set of anomalies as you had in a syndrome,

arose because of a sequence of events, not necessarily b/c they have a common genetic link

people suffering from a sequence will have similar anomalies as each other

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Association

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Diseases not necessarily related to e/o or caused by e/o… they just happen to always occur simultaneously

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Polydactyly

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too many fingers / toes

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Syndactyly

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fused fingers / toes (ie: Lobster Claw)

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Amelia

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complete absence of a limb

Usually due to Thalidomide drug

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Phocomelia

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the interconnecting middle segment of the limb is missing

Usually due to Thalidomide drug

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Meromelia

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missing part of the limb from one segment down

Usually due to Thalidomide drug

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Thalidomide

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Drug historically prescribed to pregnant women to appease discomforts of pregnancy

Known to cause amelia, phocomelia, meromelia

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Rubella

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chance of having an abnormality depends on what point in developmental time the virus infected

Greatest chance of abnormality occurs at weeks 1-4 and decreases from there

effects don’t show up until a couple of years after birth

Leads to cataracts, deafness, cardiovascular defects, mental retardation

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Cytomegalo Virus

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very high rate of spontaneous abortion

if affected early the survival rate = 0

if affected later the fetus survives but w/ significant malformations like microcephaly (retardation, blindness, deafness) and enlargement of spleen and liver

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Herpes Simplex Virus

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if affected early on there is a 3x chance of spontaneous abortion

if affected wk-20, there is an increased chance of premature delivery w/ malformations like microcephaly (retardation, blindness, deafness) and enlargement of spleen and liver

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Varicella

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Effects brain, limbs and musculature of fetus

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Syphillis

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Leads to microcephaly (retardation, blindness, deafness)
and liver, bone, dentition problems

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HIV

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Microcephaly (retardation, blindness, deafness)

Overall growth retardation

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What does fetal development depend on in regards to radiation exposure

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Depends on dose and exposure frequency

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Penicillin

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an antibiotic

Interferes w/ fetal coagulation

Leads to hemorrhage increasing rate of spontaneous abortion, preterm birth, still birth

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Streptomycin

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an antibiotic

Causing fetal hearing disorders due to effect on development of CN 8

Also causes premature births

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Tetracyclin

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an antibiotic

Causes stains on fetal mineralized tissues, anomalies in craniofacial development, overall bone growth

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Thalidomide

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For pregnancy discomforts, but it’s no longer on the market

Causes problems in fetal limbs -- amelia, phocomelia, meromelia

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Aminopterin

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anti-neoplastic drug (cancer) that works antagonistically to Folic Acid

Causes anencephaly, cleft lip & palate, 25% fetal survival

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Valium

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80% (4x) increase in cleft lip & palate

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Warfarin

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rat poison that causes the animal to bleed to death

thins out the blood to reduce clotting

Causes fetal hemorrhage leading to increased rate of spontaneous abortion, preterm birth and still birth

Use heparin because it does not cross placenta

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ACE Inhibitor

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For high blood pressure

Causes overall fetal growth retardation

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Nicotine

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vasoconstrictors

interferes w/ blood flow to the placenta causing overall growth retardation

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Cocaine

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vasoconstrictors

interferes w/ blood flow to the placenta causing overall growth retardation

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Alcohol

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Fetal Alcohol Syndrome: most commonly mental retardation

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Androgens

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male hormones can be used to prevent abortion

Causes masculinization of the girl fetus

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Diabetes

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diabetic mothers have an 80% chance of having a child born w/ some sort of mild abnormality

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Thyroid Hormone

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For maternal iodine deficiency

Causes fetal Cretinism

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Mercury Poisoning

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CNS problems = cerebral palsy, mental retardation, seizures

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Iodine deficiency

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required for normal growth regulation

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Vit C deficiency

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required for collagen synthesis

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Folic acid deficiency

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required for normal fetal neural development

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Estrogen

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Used to prevent abortions

increase chances of carcinoma of the cervix and vagina