Infections and teratogens in Pregnancy

Congenital Rubella Syndrome

HEAD: CHD, Cataracts, Deafness

Congenital CMV

DCMV: Deafness, Cacifications, Microcephaly, Ventriculomegaly

Congenital Varicella

ITCH: IUGR, corTical atrophy, Calcifications, limb/muscle Hypoplasia

Parvovirus

fetal anemia, hydrops, demise

Congenital Toxoplasmosis

GAME: Growth restriction, Ascites and hydrops, microcephaly, echogenicity

Congenital Zika

microcephaly, intercranial calcifications, hydrocephalus, hypoplastic/absent cerebellum, arthrogryposis

Trimester Risk for Rubella

1>2>3

Trimester Risk for CMV

1>2>3

Trimester Risk for Parvo

2>1>3

Trimester risk for Toxo

2,3 > 1

CMV treatments

Valgcyclovir, immunoglobulin

Varicella Treatments

VLIG at 96 hrs

Parvo treatment

fetal transfusion via PUBS

Toxo treatment

Spirimycin <18wks

Ionizing Radiation

growth restriction, microcephaly, ID, CNS effects

Maternal Diabetes (Pre-gestational)

2-3x risk anomalies, CHD, NTD, LGA, macrocephaly, renal, lower limb anomalies

Early-onset DM 2

SGA, perinatal mortality, congenital anomalies

FASD

prenantal/postnatal onset growth deficiency, cardiac defects, ID, vision/hearing issues, behavioral effects (memory, impulse control, executive functioning, attention)

Anti-Convulsants (AEDs)

4-6% anomaly incidence, Valprotal/Depakene ONTDs

Retinoic Acid

Accutane: major malformations, increased ID risk, behavioral issues, CNS, eye, ear, heart, craniofacial

Warfarin

increased risk of SAB, IUGR, epiphysial stippling, limb hypoplasia,CNS/eye anomalies, nasal hypoplasia(severe)

Cocaine

vasoconstriction and vascular disruption, fetal GR, preterm delivery, abruption, uterine rupture, fetal death, withdrawal

Angiotensin-Converting Enzyme (ACE) Inhibitors (-pril)

oligo, pulmonary hypoplasia, IUGR, persistent patent DA, skull bone hypoplasia, fetal death (2nd and 3rd tri exposures)