fetal alcohol syndrome

Fetal alcohol syndrome (FAS) is a potential syndromic complication that can occur with maternal pre-natal alcohol exposure. It is also broadly categorized as fetal alcohol spectrum disorders (FASD) due to the fact that the fetus may not show all the features and the broad spectrum of effects on the fetus from alcohol.

Epidemiology

It is considered one of the commonest preventable causes of intellectual impairment. The estimated incidence in the western world is at around 0.2-1% of live births  for FAS and ~10% for FASD . It may affect up to 20-40% of pregnancies in mothers with chronic alcohol abuse .

Clinical features

The spectrum of features include:

Facial/oral
  • short palpebral fissures
  • epicanthus
  • smooth philtrum
  • mid facial hypoplasia
  • long thin upper lip
  • delayed dental development
Cranial/CNS
Skeletal
  • delayed bone development
  • pectus excavatum 
  • vertebral segmental anomalies: congenital scoliosis
  • limb anomalies
    • fusion of upper limbs: radio-ulnar synostoses
  • stippled epiphyseal calcifications
Cardiac
Ocular/ophthalmic 
Renal
  • dysplastic kidneys
Genitourinary 
  • hypoplasia of external genitalia
Other

Complications

  • alcohol withdrawal may occur in infancy
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