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

  1. Effectiveness: 98% if initiated within the first 10 weeks of pregnancy.

  2. Administration: Take one tablet of mifepristone, followed by misoprostol 24-48 hours later.

  3. 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.