Teratogens

Isotretinoin

Purpose: acne

Features: thymic hypoplasia (absent immunity), cleft palate, CHD, hydrocephalus, microcephaly (neuro)

• ACCNE

Thalidomide

Purpose: morning sickness, leporsy

Features: limb reduction, hands and feet attached to truck

• tha’limb’domide

Valproate

Purpose: seizure

Features: cleft lip, NTD

Phenytoin

Purpose: seizure

Features: distal phalange hypoplasia, pulmonary and aortic stenosis

• “phunny” toes

Methimazole

Purpose: hyperthyroidism

Features: absent scalp skin

Lithium

Purpose: biopolar

Features: Ebstein anomaly

Maternal diabetes

Features: caudal/sacral regression, great vessels are flipped, NTD, holoprosencephaly

Maternal PKU

Features: microcephaly, IUGR, ID, cardiac defects

• P(etite), K(ardiac), U(under 70 IQ)

Maternal obesity

Features: cleft lip/palate, CHD, NTD

• Double CHiN

Alcohol

Features: facies (short philtrum, thin upper lip, short palpebral fissure, epicanthal folds), ID/DD, microcephaly, IUGR

• Fetal Alcohol Syndrome (FAS) = Face Altered CNS Small

Methotrexate

Purpose: rheumatoid arthritis

Features: miscarriage, NTD

• MethoTrexate = Miss and Tube

Trimethoprim-Sulfamethoxazole

Purpose: UTI

Features: NTD

Aminoglycosidase

Purpose: UTI

Features: HL

• can occur in mom, m.1555 A>G

• A>G = AminoGlycosidase

Tetracycline

Purpose: antibiotic

Features: grey/discolored teeth

ACE-I and ARB (ie., lisinopril and losartan)

Purpose: anti-hypertension

Features: renal agenesis

• acts on kidneys to increase urination (statin)

Warfarin

Purpose: prosthetic heart valve

Features: nasal hypoplasia, stippled epiphyses, fetal hemorrhage

• prosthetic “Walve”

Toxoplasmosis

Features: intracranial calcification, hydrocephaly, seizure, chorioretinitis

Syphilis

Features: saddle nose, saber chins, hutchenson teeth, nasal drainage, SNHL

• 5 S’s of syphilis

Parvovirus

Features: anemia, hypdrops

Varicella

Features: ventriculomegaly, skin scarring, short limbs, hydrocephalus

Rubella

Features: hepatosplenomegaly, HL, cataracts, blueberry muffin rash, CHD

• "rub” = rash

• “bell” = can’t hear or see bell

• “bell”y = hepatosplenomegaly

Cytomegalovirus

Features: cerebral calcifications, IUGR, seizure, HL, blueberry muffin rash

Herpes

Features: post natal organ damage and CNS manifestations

Zika

Features: microcephaly

• from braZil