Fetal Alcohol Syndrome

Fetal alcohol syndrome

Alcohol embryofetopathy (fetal alcoholism) combines deviations in the psychophysical development of a child that are different in both combination and severity, the cause of which is a woman’s abuse of alcohol before and during pregnancy.

The etiology and pathogenesis is based on the toxic effect of alcohol and its breakdown products (acetaldehyde, etc.) on the fetus. This is facilitated by the easy passage of alcohol through the placenta, the absence of alcohol dehydrogenase in the liver of the embryo and fetus, suppression of the synthesis of cellular and cell-free RNA, the development of alcoholic hypoglycemia, disruption of the transplacental transport of essential amino acids, zinc, etc.

The clinical picture is varied and in most cases is represented by four groups of symptoms: pre- and postnatal dystrophy; craniofacial dysmorphia; somatic deformities; brain damage.

Pre- and postnatal dystrophy is the main clinical manifestation of alcohol syndrome, which correlates with the amount of alcohol consumed by the mother during pregnancy. Children are born with low weight and insufficient body length. After a year, these children have a growth rate of 65% and a rate of weight gain of 38% of normal figures.

Craniofacial dysmorphia is so typical that it has given rise to the definition of “the face of a child with alcohol syndrome.” Characterized by a short palpebral fissure, blepharophimosis, epicanthus, ptosis, strabismus, elongated face, micrognathia, low bridge of the nose, convex upper lip, deep-set auricles, microcephaly, flattened occiput.

Somatic deformities: abnormal placement of fingers, hip dysplasia, chest deformities, shortening of the feet, hypospadias, vaginal duplication, anal fusion, congenital heart defects, cavernous angiomas, liver fibrosis, etc.

Damage to the nervous system can manifest itself immediately after birth (tremor, spontaneous clonic convulsions, opisthotonus, muscle hypotonia, etc.) and in the long term of postnatal development (mental retardation, occlusive hydrocephalus, etc.).

Based on the severity of clinical manifestations, there are 3 degrees of severity of fetal alcohol syndrome: mild, moderate and severe.

The diagnosis is made based on the mother's medical history (chronic alcohol use) and clinical manifestations. Differential diagnosis must be made with other forms of primordial dwarfism and hereditary syndromes.

Treatment is symptomatic and aimed at eliminating the main manifestations of suffering.

The prognosis is serious. Children with alcohol syndrome, in addition to medical measures, need enhanced social and legal assistance.