Podcast
Questions and Answers
What does the term teratogen refer to?
What does the term teratogen refer to?
Which of the following principles of clinical teratology indicates that there are instances where teratogens do not cause any malformation?
Which of the following principles of clinical teratology indicates that there are instances where teratogens do not cause any malformation?
What is teratology primarily concerned with?
What is teratology primarily concerned with?
Which statement reflects the incidence of congenital anomalies globally?
Which statement reflects the incidence of congenital anomalies globally?
Signup and view all the answers
What describes the possible outcomes during the pre-implantation stage of development?
What describes the possible outcomes during the pre-implantation stage of development?
Signup and view all the answers
What is the primary mechanism by which methotrexate acts as a teratogen?
What is the primary mechanism by which methotrexate acts as a teratogen?
Signup and view all the answers
Which of the following is a potential consequence during the fetal to neonatal stage as a result of teratogenic exposure?
Which of the following is a potential consequence during the fetal to neonatal stage as a result of teratogenic exposure?
Signup and view all the answers
Which of these categories does NOT fall under teratogenic agents?
Which of these categories does NOT fall under teratogenic agents?
Signup and view all the answers
How does a deficiency of energy supply affect organogenesis during pregnancy?
How does a deficiency of energy supply affect organogenesis during pregnancy?
Signup and view all the answers
Which of the following is an example of a congenital infection associated with teratogenicity?
Which of the following is an example of a congenital infection associated with teratogenicity?
Signup and view all the answers
What type of abnormity is associated with chromosomal aberration during organogenesis?
What type of abnormity is associated with chromosomal aberration during organogenesis?
Signup and view all the answers
Which of the following teratogenic agents can be classified as an environmental factor?
Which of the following teratogenic agents can be classified as an environmental factor?
Signup and view all the answers
What is a common effect of hypoxia during the fetal development stage?
What is a common effect of hypoxia during the fetal development stage?
Signup and view all the answers
What is the main consideration for using drugs during pregnancy?
What is the main consideration for using drugs during pregnancy?
Signup and view all the answers
Which of the following drug categories demonstrates that controlled human studies show no risk?
Which of the following drug categories demonstrates that controlled human studies show no risk?
Signup and view all the answers
Which category of drugs indicates that the evidence for risk outweighs any benefits?
Which category of drugs indicates that the evidence for risk outweighs any benefits?
Signup and view all the answers
What can be concluded about Category B drugs?
What can be concluded about Category B drugs?
Signup and view all the answers
Which of the following symptoms is NOT commonly associated with congenital syphilis?
Which of the following symptoms is NOT commonly associated with congenital syphilis?
Signup and view all the answers
Which of the following is an example of a Category D drug?
Which of the following is an example of a Category D drug?
Signup and view all the answers
What is a common finding in Fetal Cytomegalovirus syndrome?
What is a common finding in Fetal Cytomegalovirus syndrome?
Signup and view all the answers
What is true about Category C drugs according to the classification?
What is true about Category C drugs according to the classification?
Signup and view all the answers
Which of the following is a symptom of Fetal Rubella syndrome?
Which of the following is a symptom of Fetal Rubella syndrome?
Signup and view all the answers
Which of these drugs is associated with significant teratogenic risk?
Which of these drugs is associated with significant teratogenic risk?
Signup and view all the answers
What syndrome is associated with congenital varicella zoster infection?
What syndrome is associated with congenital varicella zoster infection?
Signup and view all the answers
Which statement regarding drug categories in pregnancy is accurate?
Which statement regarding drug categories in pregnancy is accurate?
Signup and view all the answers
Which finding is typically NOT associated with congenital herpes simplex?
Which finding is typically NOT associated with congenital herpes simplex?
Signup and view all the answers
What is one of the most common outcomes of congenital infection by Toxoplasmosis gondii?
What is one of the most common outcomes of congenital infection by Toxoplasmosis gondii?
Signup and view all the answers
What is a likely neurological consequence of congenital HIV/AIDS?
What is a likely neurological consequence of congenital HIV/AIDS?
Signup and view all the answers
Which of the following is a characteristic finding of congenital cytomegalovirus?
Which of the following is a characteristic finding of congenital cytomegalovirus?
Signup and view all the answers
What is a notable risk associated with the use of ACE inhibitors during the second and third trimester of pregnancy?
What is a notable risk associated with the use of ACE inhibitors during the second and third trimester of pregnancy?
Signup and view all the answers
What is a potential effect of taking high doses of Vitamin A during pregnancy?
What is a potential effect of taking high doses of Vitamin A during pregnancy?
Signup and view all the answers
Which antibiotics are associated with an increased risk of sensory-neural hearing loss in the fetus?
Which antibiotics are associated with an increased risk of sensory-neural hearing loss in the fetus?
Signup and view all the answers
What type of birth defects can occur as a result of using Trimethoprim during pregnancy?
What type of birth defects can occur as a result of using Trimethoprim during pregnancy?
Signup and view all the answers
What are common congenital anomalies linked with the use of anticonvulsants during pregnancy?
What are common congenital anomalies linked with the use of anticonvulsants during pregnancy?
Signup and view all the answers
Which of the following outcomes is linked to Corticosteroid use in pregnant women?
Which of the following outcomes is linked to Corticosteroid use in pregnant women?
Signup and view all the answers
What is a notable risk of using Coumadin (Warfarin) during pregnancy?
What is a notable risk of using Coumadin (Warfarin) during pregnancy?
Signup and view all the answers
What is the recommended maximum daily dose of Vitamin A during pregnancy?
What is the recommended maximum daily dose of Vitamin A during pregnancy?
Signup and view all the answers
Which condition is associated with an increased risk of specific major malformations such as spina bifida and cleft lip?
Which condition is associated with an increased risk of specific major malformations such as spina bifida and cleft lip?
Signup and view all the answers
What is the recommended daily intake of folic acid to reduce the risk of neural tube defects during pregnancy?
What is the recommended daily intake of folic acid to reduce the risk of neural tube defects during pregnancy?
Signup and view all the answers
What effect could hyperthyroidism, particularly due to Graves' disease, have on pregnancy?
What effect could hyperthyroidism, particularly due to Graves' disease, have on pregnancy?
Signup and view all the answers
Which teratogenic exposure is linked to anophthalmia and neural tube defects?
Which teratogenic exposure is linked to anophthalmia and neural tube defects?
Signup and view all the answers
Which maternal condition is NOT associated with an increased risk of early loss of pregnancy?
Which maternal condition is NOT associated with an increased risk of early loss of pregnancy?
Signup and view all the answers
What is a potential consequence of paternal exposure to toxic substances?
What is a potential consequence of paternal exposure to toxic substances?
Signup and view all the answers
What teratogenic effect is associated with malnutrition due to a lack of minerals?
What teratogenic effect is associated with malnutrition due to a lack of minerals?
Signup and view all the answers
Which of the following is a result of untreated fetal hyperthyroidism due to maternal Graves' disease?
Which of the following is a result of untreated fetal hyperthyroidism due to maternal Graves' disease?
Signup and view all the answers
Which principle of clinical teratology suggests variability in how different embryos respond to teratogens?
Which principle of clinical teratology suggests variability in how different embryos respond to teratogens?
Signup and view all the answers
What is a significant outcome during the pre-implantation stage of development when exposed to teratogens?
What is a significant outcome during the pre-implantation stage of development when exposed to teratogens?
Signup and view all the answers
Which statement reflects a characteristic of teratogenic exposures in relation to patterns of anomalies?
Which statement reflects a characteristic of teratogenic exposures in relation to patterns of anomalies?
Signup and view all the answers
Which of the following best describes the concept of teratogenicity?
Which of the following best describes the concept of teratogenicity?
Signup and view all the answers
Which statement is true regarding the incidence of congenital anomalies globally?
Which statement is true regarding the incidence of congenital anomalies globally?
Signup and view all the answers
Which of the following findings is typically associated with congenital syphilis?
Which of the following findings is typically associated with congenital syphilis?
Signup and view all the answers
What is a noted effect of congenital rubella (German measles) on the fetus?
What is a noted effect of congenital rubella (German measles) on the fetus?
Signup and view all the answers
Which symptom is most directly associated with congenital varicella zoster infection?
Which symptom is most directly associated with congenital varicella zoster infection?
Signup and view all the answers
Which of the following is a common neurological consequence of congenital herpes simplex?
Which of the following is a common neurological consequence of congenital herpes simplex?
Signup and view all the answers
What is a significant complication of congenital cytomegalovirus (CMV) infection?
What is a significant complication of congenital cytomegalovirus (CMV) infection?
Signup and view all the answers
Which of the following congenital infections is specifically linked to fetal Toxoplasmosis syndrome?
Which of the following congenital infections is specifically linked to fetal Toxoplasmosis syndrome?
Signup and view all the answers
Which category of drugs indicates that controlled animal studies are not acceptable, and no human data is available?
Which category of drugs indicates that controlled animal studies are not acceptable, and no human data is available?
Signup and view all the answers
What characteristic defines Category D drugs in terms of teratogenicity?
What characteristic defines Category D drugs in terms of teratogenicity?
Signup and view all the answers
In congenital infections, which symptom is typically NOT associated with congenital herpes simplex?
In congenital infections, which symptom is typically NOT associated with congenital herpes simplex?
Signup and view all the answers
Which condition is characterized by both gastrointestinal and genitourinary anomalies in a congenital infection?
Which condition is characterized by both gastrointestinal and genitourinary anomalies in a congenital infection?
Signup and view all the answers
Which of the following is classified as a Category X drug due to its teratogenic potential?
Which of the following is classified as a Category X drug due to its teratogenic potential?
Signup and view all the answers
Which group of drugs is represented in the examples of potential teratogens specifically for hormonal effects?
Which group of drugs is represented in the examples of potential teratogens specifically for hormonal effects?
Signup and view all the answers
What is the primary implication of categorizing a drug as Category B during pregnancy?
What is the primary implication of categorizing a drug as Category B during pregnancy?
Signup and view all the answers
What is the main concern associated with the use of ACE inhibitors during the second and third trimesters of pregnancy?
What is the main concern associated with the use of ACE inhibitors during the second and third trimesters of pregnancy?
Signup and view all the answers
Which of the following drugs is commonly noted for its teratogenic risk particularly in the context of neurodevelopmental effects?
Which of the following drugs is commonly noted for its teratogenic risk particularly in the context of neurodevelopmental effects?
Signup and view all the answers
Which of the following could result from maternal hyperthyroidism during pregnancy?
Which of the following could result from maternal hyperthyroidism during pregnancy?
Signup and view all the answers
What is a potential consequence of maternal hyperthermia during pregnancy?
What is a potential consequence of maternal hyperthermia during pregnancy?
Signup and view all the answers
Which substance is primarily linked to Minamata Syndrome due to maternal exposure?
Which substance is primarily linked to Minamata Syndrome due to maternal exposure?
Signup and view all the answers
Which of the following maternal conditions can adversely affect fetal development?
Which of the following maternal conditions can adversely affect fetal development?
Signup and view all the answers
What effect does lead exposure during pregnancy typically have?
What effect does lead exposure during pregnancy typically have?
Signup and view all the answers
Which outcome is associated with exposure to carbon monoxide during pregnancy?
Which outcome is associated with exposure to carbon monoxide during pregnancy?
Signup and view all the answers
Which developmental issues are linked to maternal hyperthermia at an early gestational stage?
Which developmental issues are linked to maternal hyperthermia at an early gestational stage?
Signup and view all the answers
What is a likely consequence of maternal exposure to nicotine?
What is a likely consequence of maternal exposure to nicotine?
Signup and view all the answers
What is a common neurological disorder result of excessive lead exposure during pregnancy?
What is a common neurological disorder result of excessive lead exposure during pregnancy?
Signup and view all the answers
What major developmental malformation is associated with insulin-dependent diabetes during pregnancy?
What major developmental malformation is associated with insulin-dependent diabetes during pregnancy?
Signup and view all the answers
How does maternal hyperthyroidism affect pregnancy outcomes?
How does maternal hyperthyroidism affect pregnancy outcomes?
Signup and view all the answers
What nutritional deficiency during pregnancy is directly linked to conditions such as anophthalmia?
What nutritional deficiency during pregnancy is directly linked to conditions such as anophthalmia?
Signup and view all the answers
What is the recommended daily intake of folic acid to minimize risks of neural tube defects during pregnancy?
What is the recommended daily intake of folic acid to minimize risks of neural tube defects during pregnancy?
Signup and view all the answers
What effect does maternal malnutrition have regarding mineral deficiencies during pregnancy?
What effect does maternal malnutrition have regarding mineral deficiencies during pregnancy?
Signup and view all the answers
What is a significant risk associated with untreated systemic lupus erythematosus during pregnancy?
What is a significant risk associated with untreated systemic lupus erythematosus during pregnancy?
Signup and view all the answers
What consequence is likely if fathers are exposed to toxic substances affecting sperm cells?
What consequence is likely if fathers are exposed to toxic substances affecting sperm cells?
Signup and view all the answers
How does maternal hyperthyroidism, particularly in the case of Grave's disease, impact fetal development?
How does maternal hyperthyroidism, particularly in the case of Grave's disease, impact fetal development?
Signup and view all the answers
Which of the following antisensory effects is linked to the use of aminoglycoside antibiotics during pregnancy?
Which of the following antisensory effects is linked to the use of aminoglycoside antibiotics during pregnancy?
Signup and view all the answers
What specific congenital defect may result from the use of Warfarin during pregnancy?
What specific congenital defect may result from the use of Warfarin during pregnancy?
Signup and view all the answers
What is the teratogenic effect associated with high doses of vitamin A during pregnancy?
What is the teratogenic effect associated with high doses of vitamin A during pregnancy?
Signup and view all the answers
Which of these drugs is likely to suppress fetal development when used during pregnancy?
Which of these drugs is likely to suppress fetal development when used during pregnancy?
Signup and view all the answers
What is a potential outcome of taking Trimethoprim in pregnancy?
What is a potential outcome of taking Trimethoprim in pregnancy?
Signup and view all the answers
Which of the following effects is most likely associated with the use of anticonvulsants during pregnancy?
Which of the following effects is most likely associated with the use of anticonvulsants during pregnancy?
Signup and view all the answers
What is one of the major risks when using ACE inhibitors such as enalapril during the second and third trimester?
What is one of the major risks when using ACE inhibitors such as enalapril during the second and third trimester?
Signup and view all the answers
Which defect is NOT commonly associated with the use of Tetracycline during pregnancy?
Which defect is NOT commonly associated with the use of Tetracycline during pregnancy?
Signup and view all the answers
Study Notes
Teratogenicity
- Teratogen: An agent that causes permanent structural or functional alterations by interfering with normal embryonic/fetal development
- Teratogenicity: The capability of producing fetal malformations
- Teratology: The science studying causes, mechanisms, and patterns of abnormal development. Exposure to a teratogen leads to teratogenicity.
Incidence of Birth Defects
- Approximately 303,000 newborns die within 28 days of birth globally due to congenital anomalies (WHO, World Birth Defects Day: March 3, 2021)
- Teratogens account for about 10% of birth defects.
- Unknown causes or factors account for about 37% of birth defects.
- Multifactorial factors contribute to about 42% of birth defects.
- Chromosomal abnormalities account for approximately 3% of birth defects.
- Monogenic disorders account for about 8% of birth defects.
Principles of Clinical Teratology
- No absolute teratogens exist
- Susceptibility to teratogens differs between individuals
- Embryogenesis and fetal development are vulnerable periods for teratogen exposure
- Multiple teratogens can interact and have more significant effects than a single teratogen
Critical Periods
- Pre-implantation (fertilization to implantation)
- Implantation to organogenesis (first two months)
- Fetal/neonatal stage (second and third trimesters)
Mechanisms of Action of Teratogens
- Interference with nucleic acids (e.g., methotrexate)
- Inhibition of enzymes
- Deficiency in energy supply needed for organ building
- Lack of necessary substrates
- Replication, transcription, or RNA translation
- Preventing folic acid formation
- Glucose deficiency
- Internal respiration interference
- Hypoxia
- Vitamin or mineral absorption issues
- Genetic mutations
- Chromosomal aberrations
Teratogenic Agents
- Infectious agents (e.g., toxoplasmosis, syphilis, CMV, rubella, varicella zoster, herpes simplex, HIV/AIDS, tuberculosis)
- Environmental chemicals and physical agents (e.g., alcohol, ionizing radiation, toluene, tobacco, maternal hyperthermia, cocaine, lead, mercury, carbon monoxide, pesticides)
- Drugs and pharmaceuticals
- Maternal disorders (e.g., diabetes, hypothyroidism, hyperthyroidism, systemic lupus erythematosus, malnutrition)
Congenital Infections (STORCH)
- Toxoplasmosis gondii
- Syphilis (Treponema pallidum)
- Cytomegalovirus (CMV)
- Rubella (German Measles)
- Varicella-zoster (Chickenpox)
- Herpes simplex
- HIV/AIDS
- Tuberculosis
Congenital Infections (examples with syndromes)
- Fetal toxoplasmosis syndrome
- Fetal syphilis syndrome
- Fetal CMV syndrome
- Fetal rubella syndrome
- Features of varicella zoster syndrome: hypoplasia, paresis, skin lesions, eye findings, CNS anomalies
Drugs and Pharmaceuticals
- All drugs have theoretical teratogenic potential.
- Medications should be carefully considered during pregnancy.
- FDA classification system for drug risk during pregnancy:
- Category A: no risk in human studies
- Category B: no risk in animal studies, limited human data
- Category C: animal studies show risk; limited human data
- Category D: Evidence of risk; potential benefits outweigh risk
- Category X: risk outweighs any potential benefits
Examples of Specific Medications and Exposures
- Angiotensin-converting enzyme (ACE) inhibitors
- Antibiotics (streptomycin, tetracycline, trimethoprim)
- Anticoagulants (coumadin/warfarin)
- Anticonvulsants
- Vitamins (vitamin A, folic acid, vitamin D, minerals)
- Corticosteroids
- Oral contraceptives
- Androgenic agents
- Acetyl salicylic acid (aspirin)
- Chemotherapy agents
- Antiparasitic agent (metronidazole)
- Lithium
Maternal Disorders
- Diabetes mellitus: increased risk of early pregnancy loss and major birth defects
- Hypothyroidism: increased risk of pregnancy loss, but not affecting fetal thyroid development
- Hyperthyroidism: increased risk of pregnancy loss
Environmental and Chemical/Physical Agents
- Alcohol (fetal alcohol syndrome)
- Ionizing radiation
- Toluene (glue sniffing)
- Tobacco (nicotine)
- Maternal hyperthermia
- Cocaine
- Lead
- Mercury
- Carbon monoxide
- Pesticides
Maternal Hyperthermia
- Temperatures above 38.9°C (102°F) over a 24-hour period or more with an intercurrent illness
- Minimal exposure (30-45 mins) in hot environments can be harmful during weeks 4-14 of pregnancy.
- Can lead to IUGR, microcephaly, central nervous system damage, among others
Tobacco (Nicotine)
- Associated with reduced fetal growth, increased prematurity risk, and death
Lead
- Found in old paint and water pipes
- Causes abortions, anemia, neurological problems, brain & MR abnormal development
Mercury
- Exposure through fish consumption or contaminated seed corn
- Associated with Minamata Syndrome.
Carbon Monoxide
- Results from incomplete combustion, inhalation leads to oxygen starvation (hypoxia) in the fetus.
- Associated with spontaneous abortion, stillbirth, and growth/development retardation.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.