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9 Teratogens

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Teratogens in

pregnancy
Ano ang TERATOGENS
Any agent that can disturb the development of an embryo
or fetus. Teratogens may cause a birth defect in the child.

teratogen may halt the pregnancy outright

teratogens include radiation, maternal infections, chemicals,


and drugs

any substance, organism, or process that causes


malformations in a fetus
TORCH

T OOXOPLASMOSIS

O THER: GONORRHEA, HEP.B, VZV,SYPHILLISO

R UBELLAO

C CYTOMEGALOVIRUS

H ERPES SIMPLES VIRUS


parasitic disease caused by the protozoan Toxoplasma gondii

he parasite spreads by the ingestion of infected meat or the


feces of an infected cat
•There may be no symptoms.
•Symptoms usually occur about 1 to 2 weeks after you come in
contact with the parasite.
•The disease can affect the brain, lung, heart, eyes, or liver.

Headache, sore throat, Fever, Muscle pain, enlarged lymph nodes

Those without symptoms typically do not need treatment.


Medications to treat the infection include an antimalarial drug and
antibiotics.
Other ( GONORRHEA )

Caused by Neisseria gonorrhea

Opthalmia neonatorum

Eye prophylaxis ( erythromycin ointment )


ophthalmia neonatorum
Others ( SYPHILIS )

Treponema pallidum

Affects—liver, kidney, adrenal glands

Copper colored maculopapular dermal rash appears


in untreated NBs

Rash appears on---palms of hand, soles of foot,


diaper area, around mouth & anus
Care management ( syphillis )

• 10 day course of penicillin G


( consult )
• Erythromycin is the substitute
antibiotic
Other—Varicella Zoster
• Caused by VZV
• Eye abnormalities
• IUGR
rubella

Mother---mild rash

Teratogenic effect---deafness, cataracts, mental/motor


challenges
CYTOMEGALOVIRUS (CMV)
•member of the virus family

Droplet infection

Fetus is neurologically challenged

Hydrocephalus, microcephaly, spasticity

Deafness, eye damage, chronic liver disease


CYTOMEGALOVIRUS (CMV)
Child skin--
Blueberry muffin ( covered with large petechiae )

Dx—blood serum

No treatment/vaccine

Routine screening for CMV during pregnancy is not


recommended

Handwashing before eating, avoid crowds


Herpes Simplex
( genital herpes infection )

Virus spread through the blood stream

1st trimester:
Severe congenital anomalies, spontaneous miscarriage

2nd/3rd trimester:
Premature birth, IUGR, continuing infection

Fetus may contact the virus from direct exposure when genital
lesion present at time of birth

Woman with history of genital herpes----CS


genital herpes infection
Herpes Simplex
( genital herpes infection )

IV/ oral Acyclovir ( Zovirax ) can be administered

Safe sex is important


Potentially Teratogenic Vaccine
Live virus vaccine ( mumps, measles, rubella,
poliomyelitis )

Live virus vaccine are contraindicated during


pregnancy

May transmit viral infection to a fetus


Teratogenic drugs
Any drug/herbal supplements maybe detrimental to
fetal welfare
Pregnant mother should not take any drug or
supplement not specifically prescribed

Drugs should be approved by MD, RN,RM

Pregnancy risk categories of drugs


Teratogenicity of ROH
Congenital deformities
Cognitive impairment

FEATAL ALCOHOL SYNDROME

- Small for gestational age, cognitively challenged

- Short palpebral fissure, thin upper lip, upturned nose


FAS
Teratogenicity of Cigarettes

Smoking is associated with infertility in woman

Risk for SID syndrome

Low birth weight—vaso constriction of uterine vessels

Secondary smoking, inhaled carbon monoxide


Metal and chemical hazards

Pesticides, carbon monoxide

Arsenic—by product of copper, lead

Formaldehyde, Hg
Radiation
Rapidly growing cells are extremely vulnerable to
destruction by radiation
Range of malformation –depending on the stage of
development of the embryo or fetus

Before implantation---fetus is killed

6 weeks after conception ---most damaging

PT is done before dx test involving x-ray


Hyperthermia/hypothermia
Hyperthermia
Interferes with cell metabolism

Saunas, hot tubs, tanning beds, work environment

Hot tubs----40 degrees Celcius, not >10 minutes

Maternal fever
-4-6 weeks causes abnormal fetal brain development, seizure
disorders, hypotonia,skeletal deformities

Hypothermia
Not well known
Teratogenic Maternal Stress

Myths, effects of being frightened or surprised while


pregnant

Maternal stress is severe---counselling


assignment
Preparing for labor
• Show
• Lightening
• Rupture of membrane
• Fetal circulation
• False labor
• True labor

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