Fetal Alcohol Syndrome

Overview

  • Incidence: 1/300 to 1/2000
  • Worst effect during first 2 months
  • 30-50% of infants born to mothers who drink >3oz pure EtOH/day will show features of FAS

Diagnosis

  • Growth failure (pre or postnatal weight, height, head circumference)
  • Characteristic facies
    • Midface hypoplasia (depressed nasal bridge)
    • Smooth and long philtrum
    • Thin upper lip
    • Short palpebral fissures, epicanthal folds
    • Narrow forehead (hirsutism over forehead)
    • Small eyes, ptosis, wide-spaced eyes
    • Microcephaly
    • Cleft lip/palate
  • Characteristic behaviour/intellectual profile
    • IQ 70-90
    • Hyperactivity
    • Failure to learn
    • NaivetĂ© when dealing with others
    • Over friendliness
    • Poor imagination at play
    • Aggressive, lack of impulse control
    • Poor self esteem due to perceived abnormality by parent

Washington criteria (rated from 1-4)

  1. Facial features
  2. Growth deficiency
  3. CNS impairment
  4. Prenatal alcohol exposure or maternal history of alcohol consumption

Management

  • Eyes – corrective lenses
  • Cleft palate – repair
  • Heart/kidney – repair
  • Skeletal abnormality
  • Behaviour – start rehab/PT early to decrease deficit
  • Speech language
  • Psychiatry – self esteem, substance abuse

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