OM VERMA ASSOCIATE PROFESSOR GRACIOUS COLLEGE OF NURSING ABHANPUR RAIPUR C.G

1. GRACIOUS COLLEGE OF NURSING RAIPUR
C.G.
EFFECT OF RADIATION, DRUGS AND
CHEMICALS
CHEMICALS
PRESENTED BY
OM VERMA
ASSISTANT PROFESSOR

2. EFFECT OF RADIATION,
DRUGS AND CHEMICALS
DRUGS AND CHEMICALS

4. Effect of lonising Radiation
Obstetric x-ray examination in
pregnancy has been largely replaced
by ultrasound examination increased
risk of childhood cancer. As general
risk of childhood cancer. As general
rule, the sensitivity of a tissue to
ionising radiation is directly
proportional to its rate of
proliferation,

5. Radiation dose and the time of exposure to
radiation. harmful, effects on the foetus
Include –
Miscarriage,
Teratogenicity (Malformations Or Birth Defects), Mental
Teratogenicity (Malformations Or Birth Defects), Mental
Retardation,
Intrauterine Growth Retardation (IUGR),
Induction Of Cancers (Such As Leukemia) That Appear In
Childhood.
The risk to the fetus is related to gestational age at exposure
and the radiation dose.

6. Risk Related to Gestational
Age
Age

7. 1. First Trimester :
It is the most radiation sensitive stage because
of very rapid foetal growth. Radiation injury
produces "all or nothing" effect and the
harmful effect usually ends in a miscarriage.
Many women are never aware that they are
Many women are never aware that they are
pregnant at the time of exposure or
miscarriage. Therefore, it is difficult to estimate
the incidence of foetal wastage due to
radiation.

8. 2. Second Trimester :
During this period, the foetus is in its
most sensitive stage of development as
major organ systems begin to
differentiate, though the overall growth
differentiate, though the overall growth
rate has slowed. Doses above the
threshold levels may cause gross
congenital malformations and mental
retardation.

9. 3. Third Trimester :
Very high doses (above 50 rem)
roentgen equivalent man (rem) during
this period may deplete cell
this period may deplete cell
(waste ) population, but will not cause
gross organ malformations.

10. Counseling the Radiation Exposed
Pregnant
Mother The above information may help the
physicians in counseling expectant mothers
who may have been exposed to ionising
who may have been exposed to ionising
radiation. It is possible to assist the patient in
assessing the implication of the exposure if a
systematic assessment of the risk is
performed. The following parameters should
be considered in the assessment :

11. 1. Menstrual history.
2. Gestational age at the time of exposure.
3. History of previous pregnancies including
that of congenital malformations.
4. Other potentially harmful environmental
factors (smoking, alcohol/drugs, malnutrition
etc.).
factors (smoking, alcohol/drugs, malnutrition
etc.).
5. Maternal/paternal age.
6. Assessing fetal exposure using dose
reconstruction techniques.
7. Attitude of the mother toward the
pregnancy.

12. EFFECT OF DRUGS
AND
AND
CHEMICAL

16. DRUGS CROSS THE PLACENTA
placenta

17. Effect of Drugs and Chemicals
A pregnant woman must eat plenty of nourishing food,
get plenty of rest, exercise regularly and give up
smoking, alcohol, and drugs. Many drugs and chemicals
may have carcinogenic effects on the developing foetus,
eg, diethyl-stilbestrol (a hormone used for threatened
abortion vaginal bleeding before 20 weeks gestational
abortion vaginal bleeding before 20 weeks gestational
age in some countries). Drugs may harm both the
mother and the baby. Virtually all illegal drugs such as
heroin and cocaine, and some legal substances such as
alcohol, tobacco and certain medical drugs are
dangerous for the health of mother and her baby.

18. = Some drugs are harmful at any stage of pregnancy.
=Some drugs and alcohol do maximum harm at the stage of organ
formation i.e., within the first 10th weeks of pregnancy.
= Some drugs affect the fetal growth after about the 10th week.
Continuous use of drug increases the risk of miscarriage and
Continuous use of drug increases the risk of miscarriage and
premature delivery.
= Some drugs can be especially harmful at the end of pregnancy,
making delivery more difficult or dangerous or may affect the health
of newborn.

19. ALCOHOL
Alcohol is by far the number one fetal teratogen,
especially in the early weeks. Intrauterine exposure to
even a small amount of alcohol may result in fetal
alcohol syndrome (FAS),
alcohol syndrome (FAS),
The symptoms of FAS may include –
= Slow growth before and after birth,
= Abnormal facial features (congenital abnormalities ),
= Defective heart and other organs,
= Malformed limbs,

20. = Genital Abnormalities
= Central Nervous System Damage.
= Behavioral Problems, Such As Hyperactivity,
= Extreme Nervousness,
= Reduced Ability To Concentrate
= Reduced Ability To Concentrate
medical experts agree that a woman should avoid alcohol
entirely when she decides to become pregnant or at least
when the first signs of pregnancy appear. even mild drink as
beer and wine should be avoided.

21. COCAINE AND METHAPHETAMINE
Cocaine and methaphetamine are
powerful stimulants of the central
nervous system. They suppress mother's
powerful stimulants of the central
nervous system. They suppress mother's
appetite, cause constriction of blood
vessels, increase the heart beat and the
blood pressure to soar.

22. The adverse effects on the fetus are
higher risk
Retarded growth, attention and orientation
problems, hyperirritability, a tendency to stop
problems, hyperirritability, a tendency to stop
breathing, malformed or missing organs,
strokes and seizures. The risks of spontaneous
abortion, premature birth and stillbirth also
increase with fetal exposure to cocaine and
methaphetamine.

23. With use of these drugs late in
pregnancy, the newborn may become
drug dependent and suffer from
withdrawal symptoms, such as tremors,
sleeplessness, muscle spasm, and
sucking difficulties. Learning difficulties
sucking difficulties. Learning difficulties
may develop later.

24. Cigarette Smoking
Strong evidence implicates smoking during
pregnancy as a cause of low infant birth weight
There is also a strong association between
There is also a strong association between
smoking and a higher foetal and infant
mortality rate. Smoking women have a much
higher risk of an ectopic pregnancy. Cigarette
smoke may be teratogenic and may cause
cardiac abnormalities as well as anencephaly.

25. Maternal smoking also is a significant factor in
the development of cleft lip and palate and has
been linked with sudden infant death
syndrome (SIDS). Infants nursing from smoking
mothers have also been found to have an
increased incidence of gastrointestinal
disturbances. Even a mother's exposure to
increased incidence of gastrointestinal
disturbances. Even a mother's exposure to
second hand cigarette smoke during pregnancy
or while nursing predisposes her baby to
increased incidence of respiratory problems
including bronchitis and pneumonia, during the
first year of life.

26. • Heroin and other Narcotics
Use of heavy narcotics increases the danger of
premature birth accompanied by low birth
weight, breathing difficulties, low blood sugar
weight, breathing difficulties, low blood sugar
(hypoglycaemia) and intracranial haemorrhage.
The newborn becomes drug dependent and
suffers from withdrawal symptoms, such as
irritability, vomiting and diarrhoea and joint
stiffness.

27. •Women who use contaminated needles to
inject narcotics are prone to become HIV
infected and obviously run a risk of passing 'he
virus on to their babies.
• Inhalants
• Inhalants
At least one inhalant, the organic solvent
toluene that is widely used in paints and glues,
appears to cause malformations like those
produced by alcohol. It is possible that all
organic solvents may cause birth defects.

28. Other Teratogens
Other teratogens include pesticides; industrial
chemicals; some hormones; antibiotics; oral
chemicals; some hormones; antibiotics; oral
anticoagulants, anticonvulsants, antitumour
agents, thyroid drugs, thalidomide, and
numerous other prescription drugs cause birth
defects