P6-A-Common-teratogens
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Title
COMMON TERATOGENS
Instructor: ODESSA S. BUGARIN, MAN
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Definition of Teratogens
Teratogen: A substance that interferes with normal fetal development, leading to congenital disabilities.
Exposure: Can occur via ingestion or environmental exposure during pregnancy.
Timing: Teratogens can begin affecting the developing embryo as early as 10 to 14 days after conception.
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Abortifacients
Definition: Any substance that induces abortion.
Mifepristone: Causes breakdown of uterine lining when administered early in pregnancy.
Misoprostol: Induces expulsion of the embryo.
Methotrexate: Blocks rapid cell division in the embryo and placenta when given by injection.
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Types of Teratogens
Alcohol: Causes defects or abnormalities in the developing embryo or fetus; affects central nervous system.
Chickenpox (Varicella): Rare but serious teratogen that can include congenital varicella syndrome.
Medications and Recreational Drugs: Can include various substances.
Neonatal Issues: Health problems like Diabetes and exposure to Chemicals (e.g., BPA).
Safe Agents: Non-teratogenic agents such as spermicides and prenatal vitamins (e.g., Acetaminophen, limited caffeine to 200mg/day).
Timeline of Effects
Exposure duration from conception to full gestation (0 – 40 weeks).
Risk of teratogenic effects from 10-14 days post-conception to delivery.
Specific mention of chickenpox resulting in neural tube defects.
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Specific Teratogens and Their Effects
Nicotine: Constricts uterine blood vessels, reducing O2 and nutrient supply to the embryo.
Alcohol: A primary drug abused during childbearing age; can lead to Fetal Alcohol Syndrome.
Tetracycline: Deposits in bones and teeth of the embryo, leading to yellow staining of teeth and inhibited bone growth.
Retinoic Acid (Vitamin A): Increases risk of craniofacial dysmorphisms and cleft palate particularly during the 2nd to 5th week of gestation.
Thalidomide: Notorious for causing limb abnormalities and critical in the 24-36 days post-fertilization.
Chemotherapeutic Agents: Inhibit rapidly dividing cells causing intrauterine growth retardation.
Anticonvulsant (Phenytoin): Can cause intrauterine growth restriction and microcephaly.
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Additional Teratogenic Concerns
Congenital Rubella Syndrome: Manifesting in deafness, cardiac malformations, and cataracts.
Ionizing Radiation: Can result in cell death and chromosome injury when exposed (e.g., X-rays, CT scans).
Diabetes in Mothers: Increased risk of congenital heart disease and other complications if uncontrolled.
Chickenpox: Can lead to congenital varicella syndrome with various severe outcomes.
Mechanical Forces: Restrictions such as radiation or vibration can lead to congenital conditions like clubfoot.
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BPA and Other Non-Teratogenic Considerations
BPA (Bisphenol A): Found in plastics; potential teratogenic effects still unclear, but recommendations to limit exposure during pregnancy exist.
Caffeine: Not a teratogen, yet should be limited to 200mg daily to avoid possible impacts on fetal health.
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Definition of Abortion
Abortion: The expulsion of a fetus from the uterus before it reaches viability (usually around 20 weeks of gestation).
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Classification of Abortion
Induced Abortion: Purposefully brought on due to:
Preservation of mother’s health.
Rape or incest.
Prevention of serious health issues in the fetus.
Social or economic reasons.
Spontaneous Abortion: Also known as miscarriage, occurring due to various medical issues.
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Types of Abortions
Medication Abortion: Utilizes medicines (e.g., misoprostol, methotrexate) to end pregnancy.
Procedural Abortion: Surgical options to remove fetus including vacuum aspiration for incomplete pregnancies.
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Medical Abortion Overview
Definition: Ends pregnancy using medications rather than surgery.
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How Medical Abortion Works
Effectiveness: 98% if initiated within the first 10 weeks of pregnancy.
Administration: Take one tablet of mifepristone, followed by misoprostol 24-48 hours later.
Expectations and Side Effects: Light bleeding, cramping; seek urgent care with severe side effects.
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Types of Pregnancy Complications (Abortion Types)
Threatened Abortion: Bleeding/cramping; monitored with bedrest.
Inevitable Abortion: Cervical dilation, persistent hemorrhage; requires counting pads and emotional support.
Incomplete Abortion: Some conception parts expelled; treated with D&C.
Complete Abortion: All parts of the conception expelled; observation needed.
Missed Abortion: Fetus dies but is not expelled; monitored for infections or complications.
Habitual Abortion: History of multiple abortion due to incompetent cervix; may require a cerclage procedure.
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Danger Signs of Pregnancy
Symptoms such as swelling, severe headaches, abdominal pain, vaginal bleeding, etc. indicating potential complications.
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Fertility Vitamins for Women
Folic Acid (Vitamin B9): Reduces neural tube defects (400 micrograms - 1 mg daily).
Vitamin D: Essential for hormonal health; needs regular sunlight exposure.
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Additional Fertility Vitamins for Women
Fish Oil: Supports brain development; recommended 300mg daily.
Coenzyme Q10 (CoQ10): Enhances egg quality, especially for women over 40.
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More Fertility Boosters for Women
Selenium: Promotes healthy uterine follicles; 60mcg daily recommended.
Vitamin E: Acts as an antioxidant and supports egg quality for later pregnancies.
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Antioxidants for Fertility
Glutathione: Protects eggs from oxidative damage; crucial for quality egg development.
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Fertility Vitamins for Men
Folic Acid: Improves sperm health.
CoQ10: Increases sperm count and improves morphology; 200mg twice daily suggested.
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Importance of Nutrients for Men
Selenium: Improves sperm motility; important for conception rates.
Zinc: Essential for sperm quality; 66mg daily recommended along with folic acid.
Fish Oil: 200mg twice daily to enhance semen quality.