Topic: EXAMPLE OF TERATOGENS

Teratogens are drugs, chemicals, or even infections that can cause abnormal fetal development.
There are billions of potential teratogens, but only a few agents are proven to have teratogenic
effects.

These effects can result in a baby being born with a birth odefect.

Approximately 4 to 5 percent of birth defects are caused by exposure to a teratogen.

The majority of agents that people come into contact with arent proven teratogens.

Researchers believe a teratogen can affect a developing fetus about 10 to14 days after
conception.

The best way to reduce the risk of exposure to teratogens during pregnancy is to avoid taking
medications when possible and to avoid exposure to the following:

Excessive Heat

A high core body temperature of a mother can result in an increased risk for birth defects,
particularly during the first trimester. Pregnant women should avoid hot tubs, steaming hot baths,
saunas, heating pads and computers on their lap. Maximum intensity workouts may also raise the
body temperature to dangerous levels. Pregnant woman should opt for walking, swimming or
yoga over marathons.

Herbal Treatments

Herbs may contain substances that can cause miscarriage, premature birth, uterine
contractions, or injury to the fetus. Few studies have been done to measure the effects of various
herbs on pregnant women or fetuses.

The following herbs are considered Likely Unsafe or Unsafe during pregnancy.

Saw Palmetto when used orally, has hormonal activity

Goldenseal when used orally, may cross the placenta
Dong Quai when used orally, due to uterine stimulant and relaxant effects
Ephedra when used orally
Yohimbe when used orally
Pay D Arco when used orally in large doses; contraindicated
Passion Flower when used orally
Black Cohosh when used orally in pregnant women who are not at term
Blue Cohosh when used orally; uterine stimulant and can induce labor
Roman Chamomile when used orally in medicinal amounts
 Pennyroyal when used orally or topically

Ionizing Radiation

If your doctor orders a test with possible radiation exposure during your pregnancy, they
must strongly believe that the risk of exposure is less than the risk of an untreated or
undiagnosed condition. In most cases, the lower abdomen can be shielded with a protective
apron to prevent exposure.

Children with Runny Noses, Rashes, and Fevers

It isnt always possible to avoid sick children, and in most cases, exposures only lead to
minor illnesses. When you can, its best to avoid such exposures while youre pregnant.
Every parent knows that the easiest place to acquire an illness is in a day care center or school, so
avoid these locales as much as possible.

Certain infections can be passed from child to adult, including chickenpox, rubella, and
cytomegalovirus (CMV). Adults are immune to many of these diseases. In some cases, however,
the exposure may result in an infection that can affect the baby while in the womb. If youve
been exposed to a known viral or bacterial illness, call your doctor right away so they can decide
whether a blood test is needed.

Toxoplasmosis

Toxoplasmosis is an infection that can be transmitted from cat feces to humans. If

youre pregnant and have a cat, you should minimize your exposure to the litter box as much as
possible. Ask someone else in your household to clean the litter box. If you dont have anyone to
help you with the litter, clean the litter box every day to reduce your risk of contracting
toxoplasmosis. You dont need to get rid of your cat.

Known Teratogens

You should also avoid known teratogens. These include

angiotensin converting enzyme (ACE) inhibitors, such as Zestril and Prinivil

alcohol
aminopterin
androgens, such as methyltestosterone (Android)
busulfan (Myleran)
carbamazepine (Tegretol)
chlorobiphenyls
cocaine
coumarins
warfarin (Coumadin)
cyclophosphamide (Cytoxan)
danazol (Danocrine)
 diethylstilbestrol (DES)
etretinate (Tegison)
isotretinoin (Accutane)
lead
lithium (Eskalith)
mercury
methimazole (Tapazole)
methotrexate (Rheumatrex)
penicillamine (Depen, Cuprimine)
phenytoin (Dilantin)
phenobarbital (Solfoton)
propylthiouracil (PTU)
prostaglandins
radioactive iodine
tetracycline (Sumycin)
tobacco
trimethadione (Tridione)
valproic acid (Depakene)

Some of these agents are easy to avoid. Others may be required for a medical condition and are
unavoidable. For instance, you may require phenytoin to control your seizures if youre pregnant
and you have epilepsy. Despite the risk of teratogenic effects, you may be better off taking the
phenytoin than risking the occurrence of uncontrolled seizures during pregnancy.

If you need treatment with any of the medications that are known teratogens and youre
pregnant, ask your doctor to send you to a geneticist. Geneticists specialize in the effects of
teratogens on fetuses and can help you assess your actual risk given a specific exposure. You
may also receive a targeted ultrasound evaluation to determine whether the fetus has been
affected in some way.
Some examples of teratogens known to cause human confirmation are listed in
the table below. A few of the most common examples will be discussed below.

Nicotine does not produce congenital malformations but nicotine does have an
effect on fetal growth. Maternal smoking is a well-established cause of
intrauterine growth restriction. Heavy cigarette smokers were also more likely to
have a premature delivery. Nicotine constricts uterine blood vessels and causes
decreased uterine blood flow thereby decreasing the supply of oxygen and
nutrients available to the embryo. This compromises cell growth and may have
an adverse effect on mental development.

Alcohol is a common drug abused by women of childbearing age. Infants born to

alcoholic mothers demonstrate prenatal and postnatal growth deficiency, mental
retardation, and other malformations. There are subtle but classical facial
 features associated with fetal alcohol syndrome including short palpebral
fissures, maxillary hypoplasia, a smooth philtrum, and congenital heart disease.
Even moderate alcohol consumption consisting of 2 to 3 oz. of hard liquor per
day may produce the fetal alcohol effects. Binge drinking also likely has a
harmful effect on embryonic brain developments at all times of gestation.

Tetracycline, the type of antibiotic, can cross the placental membrane and is
deposited in the embryo in bones and teeth. Tetracycline exposure can result in
yellow staining of the primary or deciduous teeth and diminished growth of the
long bones. Tetracycline exposure after birth has similar effects.

Anticonvulsant agents such as phenytoin produce the fetal hydantoin syndrome

consisting of intrauterine growth retardation, microcephaly, mental
retardation, distal phalangeal hypoplasia, and specific facial features.

Anti-neoplastic or chemotherapeutic agents are highly teratogenic as these

agents inhibit rapidly dividing cells. These medications should be avoided
whenever possible but are occasionally used in the third trimester when they are
urgently needed to treat the mother.

Retinoic acid or vitamin A derivatives are extremely teratogenic in humans. Even

at very low doses, oral medications such as isotretinoin, used in the treatment of
acne, are potent teratogens. The critical period of exposure appears to be from
the second to the fifth week of gestation. The most common malformations
include craniofacial dysmorphisms, cleft palate, thymic aplasia, and neural
tubedefects.

The tranquilizer thalidomide is one of the most famous and notorious teratogens.
This hypnotic agent was used widely in Europe in 1959, after which an estimated
7000 infants were born with the thalidomide syndrome or meromelia. The
characteristic features of this syndrome include limb abnormalities that span
from absence of the limbs to rudimentary limbs to abnormally shortened
limbs.

Additionally, thalidomide also causes malformations of other organs including

absence of the internal and external ears, hemangiomas, congenital heart disease, and congenital
urinary tract malformations. The critical period of exposure appears to be 24 to 36 days after
fertilization.
Each organ of an embryo has a critical period during which its development may
be disrupted. The type of congenital malformation produced by an exposure
depends upon which organ is most susceptible at the time of the teratogenic
exposure.
Specific types of major malformations and the times of development usually
associated with exposure to the teratogenic agent are outlined in the table below.

Sources: http://www.healthline.com/health/pregnancy/teratogens#3