SHORT TALK TOPIC

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2. When a woman consume alcohol during pregnancy, she
risks giving birth to a child who will be born with fetal
alcohol syndrome (FAS) characterized by
1) characteristic facial anomalies
(2) growth retardation and
(3) CNS involvement (cognitive impairment, learning
disabilities, or behavioural abnormalities).
It affects fetal , neonatal and childhood life.
100% Avertable Disability #1 Cause of Mental Retardation
The risk of FAS more if alcohol is consumed in first FOUR
weeks
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4. •
Alcohol can cause permanent
damage to a baby before most
women realize they are
pregnant.
The effect of alcohol on fetus
show spectrum of disorders
called as fetal alcohol spectrum of
disorders (FASD) and
FETAL ALCOHOL SYNDROME(FAS)
is severe one out of them
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5. FETAL ALCOHOL SPECTRUM OF DISORDERS (FASD)
 Fetal Alcohol Syndrome (FAS):
Abnormal characteristic facial features, growth problems, and central
nervous system (CNS) problems. People with FAS can have problems with
learning, memory, attention span, communication, vision, or hearing.
 Alcohol-Related Neurodevelopmental Disorder (ARND):
Intellectual disabilities and problems with behavior and learning, POOR
memory, attention, judgment, and poor impulse control.
 Alcohol-Related Birth Defects (ARBD): cleft palate,/lip, congenital heart,
kidney diseases , foot anomalies
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6. PATHOPHYSIOLOGY
• Alcohol crosses the placenta and rapidly reaches the fetus
• Fetus liver does not have significant alcoholdehydrogenase(ADH), ALDH
and other antioxidants like glutathion
• Also amniotic acts as reservoir for alcohol, prolonging fetal exposure
• Acetaldehyde( metabolite of ethanol) disrupt cellular differentiation and
growth, disrupting DNA and protein synthesis and inhibits cell migration
• Acetaldehyde and ethanol modify metabolism of carbohydrate, protein
and fats
• They both also decrease the transfer of amino acids, glucose, folic acid,
zinc and other nutrients across the placenta barrier which affects fetal
growth.
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7. Dark lines = Great fetal sensitivity
Light lines = Continued alcohol sensitivity
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8. Alcohol Exposure During the Pregnancy Trimesters
First:
During the first trimester, alcohol interferes with the migration and organization
of brain cells and the formation of the CNS.
Second:
Heavy drinking during the second trimester, particularly from the 10th to 20th
week after conception, seems to cause more clinical features of FAS than at
other times during pregnancy.
Third:
During the third trimester, the hippocappus is greatly affected, which leads to
problems with encoding visual and auditory information (reading and math) and
the inability to form or retain new memories.
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9. PREVALENCE
The incidence of fetal alcohol syndrome in the United States is estimated to be 1-2
cases per 1000 live births.
Worldwide in all races and ethinicity where female drinks alcohol .
It is 44% among drinker mothers .
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11. In India due to rising female aspirations and
changing lifestyle increased alcoholism among
female in metro cities risking pregnancies for FAS
Some states in India is having high prevalence of
female alcohol drinking which leads to FAS babies .
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12. Symptoms:
1) characteristic facial anomalies
(2) growth retardation and
(3) CNS involvement (cognitive impairment, learning disabilities, or behavioural
abnormalities).
1) characteristic facial
anomalies
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14. • (2) Growth retardation
• Intrauterine growth retardation (IUGR) ,
• Low birth weight (LBW ),
• Weight below 10th percentile
• Height below 10th percentile
• Small head size
• DELAYED DEVELOPMENTAL MILESTONES
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16. (3) CNS involvement :
(cognitive impairment, learning disabilities, or behavioral abnormalities).
 Poor coordination
 Hyperactive behavior
 Difficulty with attention
 Poor memory
 Difficulty in school (especially with math)
 Learning disabilities
 Speech and language delays
 Intellectual disability or low IQ
 Poor reasoning and judgment skills
 Sleep and sucking problems as a baby
 Vision or hearing problems
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17. Fetal Alcohol Effects or FAE
FAE is not as easily identifiable as FAS because there may be fewer
physical abnormalities, but knowledge of maternal use of alcohol makes it
certain that brain damage has occurred.
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18. Criteria For Diagnosis Of FAS :
A diagnosis apart from `History of alcohol consumption
during pregnancy` requires
the presence of all three of the following:
1. Documentation of three facial abnormalities
smooth philtrum
thin vermillion border
small palpebral fissures
2. Documentation of growth deficits
3. Documentation of CNS abnormalities
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19. CONTROL AND PREVENTION:
FAS is non treatable non curable condition but its 100% preventable .
FAS children can be helped to ease the life by early diagnosis
Neuropsychological Assessments
Early Intervention (Age 0 to 3)
Special Education Services
Parent and Caregiver Education
Physical, Speech and Language and Occupational Therapies
Social Skills training
Social awareness and resolutions for prevention of alcohol use and deaddiction
programme .
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20. CONTROL AND PREVENTION:
In India The North east States Tribal FASD project seeks to reduce incidence of
FASD and assist the tribal community to improve quality of life WITH FASD and
prevention of FASD
WE MUST ALSO PROMOTE HOLISTIC HEALING THROUGH TRADITIONAL AND
DEVELOPMENTALLY APPROPRIATE TECHNIQUES THAT ADDRESS THE
PHYSICAL, INTELLECTUAL, EMOTIONAL AND SPIRITUAL NEEDS OF
INDIVIDUALS AFFECTED BY FASD
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23. References:
1. J Trop Pediatr. 2012 Feb;58(1):19-24. doi: 10.1093/tropej/fmr015.
Epub 2011 Feb 14.Fetal alcohol spectrum disorders--a case-control
study from India.Nayak R, Murthy P, Girimaji S, Navaneetham J.
2. Bulletin of the World Health Organization 2011;89:398–399. Fetal
alcohol syndrome: dashed hopes, damaged lives
3. Gregory C. &Kupesky, Regina H. (2002). Parenting the Hurt Child:
Helping Adoptive Families Heal and Grow. Pinon Press. Retrieved
December 23,2009.
http://www.faslink.org/strategies_not_solutions.pdf
4. Learning about FASD (2009). Retrieved from
http://www.fasdoutreach.ca/elearning/learning-about-fasd
5. Mayo Clinic (2009). Fetal Alcohol Ayndrome. Retrieved December 28,
2009, from http://www.mayoclinic.com/health/fetal-alcohol-
syndrome/DS00184/ DSECTION=symptoms.
6. National Institute on Alcohol Abuse and Alcoholism (n.d.). Module 10K
Fetal Alcohol Exposure. January 2, 2010.
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25. THANK YOU
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