Maternal Physiology, Fetal Development

ANP and BNP

Regulate blood volume by natriuresis, diuresis and vascular smooth muscle relaxation

BNP

Increase in Severe Preeclampsia

(ANP or BNP)

Prostacyclin

• Regulates blood pressure and platelet function

• Maintain Vasodilation

• Decrease amount related to preeclampsia

Pituitary Enlargement

Primarily caused by estrogen-stimulated hypertrophy and hyperplasia of the lactotrophs.

Thyrotropin

• Stimulates maternal FT4 secretion

• Crosses the placenta

• Stimulates fetal FT4 secretion

hCG

• Inhibits maternal secretion of thyrotropin

• Crosses the placenta

• Stimulates FT4 secretion

Mullerian Ducts (Paramesonephric ducts)

The fallopian tubes, uterus, and upper vagina are derived from the ________.

FETOTOXIC AGENT (Page 9-

Aminoglycosides (Gentamicin or Streptomycin)

Effects: Preterm infants: nephrotoxicity and ototoxicity

Chloramphenicol

Neonates: Gray baby syndrome

Not Teratogenic

Nitrofurantoin

1st trim: hypoplastic left heart syndrome, microphthalmia/ anophthalmia, clefts and ASD

Sulfonamides

1st Trim: anencephaly, left ventricular outflow tract obstruction, choanal atresia diaphragmatic hernia

Tetracyclines

> 25 weeks AOG: Yellowish-brown discoloration of deciduous teeth

corticosteroids

Effects: Cleft

Mycophenolic acid

• Miscarriage

• Ear defects

Diethylstilbestrol

(F) hypoplastic, T-shaped uterine cavity, cervical collars, breast cancer

(M) Epididymal cysts, hypospadias, cryptorchidism

Warfarin

• Embryopathy

• Stippling of vertebrae

• Nasal hypoplasia

• Choanal atresia

Methotrexate

“ clover-leaf”skull

Radioiodine

Irreversible hypothyroidism

Mercury

Developmental delay, microcephaly and severe brain damage

Retinoids

• Most potent teratogen: isotretinoin

• Cranial-neural crest defects

Retinol

> 10,000 mIU/day causes defects

SSRI/SNRI

Neonatal behavior syndrome

Paroxetine (SSRI)

ASD and VSD

Lithium

Ebstein anomaly: apical displacement of tricuspid valve

anti-psychotics

Abnormal extrapyramidal muscle movements

Down syndrome

• Trisomy 21

• Most common non-lethal trisomy

Edward Syndrome

• Trisomy 18

• “Strawberry syndrome” cranium

Patau Syndrome

• Trisomy 13

• Holoprosencephaly

Turner Syndrome

• 45,X

• Only monosomy compatible with life

Klinefelter Syndrome

47, XXY

Most common sex chromosome abnormality

Cri du chat

• Microdeletion

• Abnormal laryngeal dev’t with cat-like cry