Fetal Alcohol Syndrome

There is such a medical concept as an alcoholic fetus syndrome is a collective term, meaning certain deviations in the development of the baby. And such deviations can be both physical and mental. The reason for this phenomenon is the acceptance by the future mother of alcoholic beverages.

The disease is based on the intoxication of the fetus with alcohol through the placental barrier, which leads to problems with the liver, metabolism, etc.

[1], [2], [3], [4], [5]

Causes of the alcoholic fetus syndrome

The first mention of the alcohol syndrome of the fetus was recorded as far back as the 19th century - by a French scientist who investigated the relationship between mother's alcoholism and the developmental lag. The collected and identified symptoms were later combined into a syndrome that was called alcoholic, or fetal.

The survey shows that potential future mothers do not have a clear idea of how much alcohol can be harmful to the health of the baby. Moreover, many people tend to argue that red wines can even benefit if they are consumed in the second half of pregnancy. Nevertheless, studies have shown that alcohol is dangerous not only during gestation, but even before the onset of this period - at the planning stage.

[6], [7], [8]

Pathogenesis

The pathogenesis of the development of alcoholic fetal syndrome can be described as follows:

• when a woman drinks alcohol, ethyl alcohol without problems gets through the placenta to the growing fetus;
• the level of ethyl alcohol in the developing baby's blood is higher than its amount in the woman's bloodstream, since the fetal liver neutralizes ethanol more slowly than it does in the adult body;
• Ethyl alcohol inhibits the passage of oxygen and nutrition to tissues, including the brain of the fetus.

The more and more alcohol is taken by the future mother, the more likely the development of violations in the child.

[9], [10], [11], [12]

Symptoms of the alcoholic fetus syndrome

The first signs of an alcoholic fetus syndrome appear immediately after the birth of the baby and represent physical and mental abnormalities. Such violations do not pass independently and remain with a person for life.

Fetal alcohol syndrome of the fetus is primarily manifested by mental deficiencies - it can be nervous disorders, mental underdevelopment, behavioral characteristics, intellectual backwardness, dissonance of brain functions. As the child grows up, the lag in body weight and growth becomes noticeable: however, sometimes it is noticeable when the baby is born. Often such babies are born prematurely, or have a low body weight.

There are also external differences of children:

• shortening of the eye slits, possibly - strabismus;
• narrow forehead, underdeveloped chin;
• inexpressive nasolabial groove;
• thinning of the upper lip;
• omission of the eyelids;
• microcephaly;
• signs of blepharophimosis.

External signs remain in the person for ever, therefore to diagnose an alcoholic fetus syndrome it is possible without dependence from age.

Among the internal anomalies most often found heart valve flaws, defects in vascular development, fusion of the anus, deformation of the osseous system, short extremities.

Often children have problems with visual and auditory function, they are inhibited (so-called slow-witted). In educational institutions it is difficult for them not to lag behind other children: they have a bad memory, sometimes they are not able to control their emotions and mood. Because of the complexity of adaptation, it is recommended to give such children to special schools.

[13]

Complications and consequences

• A child with alcohol syndrome may have a number of physical and mental disorders that remain with him for life. Even at an older age a person remains excessively emotional, irritable, it is difficult to concentrate and remember any information.
• Often, especially in adolescence, a child can not establish contact with classmates, it is difficult for him to communicate with teachers. Conflict with others gradually increases, and over time can lead to crime.
• Very high likelihood of a predilection for alcohol.
• Possible violations of reproductive function in the future.

[14], [15], [16],

Diagnostics of the alcoholic fetus syndrome

The diagnosis of alcoholic fetal syndrome can be established, based on anamnestic data, information on the features of the course of pregnancy and labor. Also takes into account the condition of the baby after birth, his assessment on the Apgar scale.

During the growing up of the child attention is drawn to the dynamics of its development, the parameters of growth and weight.

[17], [18], [19], [20]

Differential diagnosis

Differential diagnosis is usually difficult, since this pathology does not have any specific symptoms, and it is easily confused with other psychoneurological abnormalities. To confirm the diagnosis, the important thing is to exclude the blood relationship of the parents.

Instrumental diagnostics involves the use of the following techniques:

• examination on the apparatus "Malysh" and "Aloka";
• phono and electrocardiogram during pregnancy;
• an electroencephalogram of a newborn's brain;
• X-ray of the bone system of the baby.

In particular, with EEG, the child can be determined by a significant synchronization of the rhythm of sleep and other disorders.

Laboratory diagnostic methods include analyzes for the content of ethanol, carboxyhemoglobin and nicotine in the bloodstream in a pregnant woman and in blood taken from an umbilical vessel. Less relevant are chromosome analyzes and evaluation of serum enzymes.

Treatment of the alcoholic fetus syndrome

Unfortunately, it is not possible to cure the alcoholic fetus syndrome, as defects and malfunctions in the work of organs are already laid in the period of intrauterine growth of the baby. Nevertheless, treatment is still necessary: often it is aimed at alleviating the symptoms of the disease and even prolonging the life of the patient.

So, if necessary, surgery is performed to correct the heart valves or digestive tract. In addition, the child should be registered with a neurologist and at an older age regularly attend classes of a psychologist. All this will allow to direct the behavior of the baby and facilitate its social adaptation.

The possibility of facilitating the course of the pathology is based on the characteristics of the child's organism and the degree of damage to its nervous system.

• Medicines for alcoholic fetal syndrome are prescribed to stabilize and improve metabolic processes in the brain. Thanks to this, it is possible to maintain and activate working structures, to provoke functional systems for reorganization.

For this purpose, biostimulators are often used in neurology, which can restore the functions of neurons, improve the exchange of oxygen and nutrition in nerve cells. We bring to your attention brief characteristics of such drugs.

• Nootropil is a nootropic agent that improves cognitive processes in the brain. The drug is prescribed to children in quantities of 3.3 grams per day, depending on the indications. Do not take the drug if the child's age is less than 1 year.
• Encephalbol is used in the retardation of mental development, cerebroasthenia, encephalopathy, oligophrenia, as well as exogenous intoxications. The drug is not prescribed for children under 7 years. Method of application - inside, 1-2 tablets up to 3 times a day. The course of treatment is no less than 2 months.
• Pantogam - prescribed for organic disorders in the brain, as well as with neurotic disorders. Pantogam is not recommended for admission to 18 years of age. The drug is taken orally, 20 minutes after a meal, 1-4 capsules up to 3 times a day. The duration of treatment is determined by the doctor and can last several months in a row.
• Semax is a synthetic analog of corticotropin, which has a pronounced effect on the processes of memorization, learning and adaptation. The drug is used, like drops in the nose, 3 drops in each nasal passage, up to 3-4 times a day. Of the contraindications - allergy, the period of pregnancy and breastfeeding.
• Neuromidine is an inhibitor of cholinesterase. Improves the transmission and conductivity of nerve impulses, facilitates the memorization process. Neuromidine is not prescribed for gastrointestinal illnesses, with cardiac pathologies, and also in childhood. The scheme of reception - ½ or 1 tablet up to 3 times a day. Duration of therapy - up to 2 months.

Stimulation of the functional capacity of nerve cells, the restoration of the conduction of nerve impulses and the formation of neural connections are realized through the use of ganglioside preparations such as Cronassial and Biosinax.

Widely used and preparations-hydrolysates, which reduce oxygen fasting of the brain and strengthening neurons. The most common representative of hydrolysates is Cerebrolysin.

The above types of drug treatment of alcoholic fetal syndrome are aimed at compensating for neuropsychiatric disorders by restoring the affected nerve cells. But it should be noted that the general lack of neurons can not be filled, so a complete cure is a question that can not be realized.

Replenishment of the lack of nerve cells is a problem that scientists-neurologists around the world are working on. One of the most promising options for solving this problem may be stem cell transplantation. However, at present, this method of treatment is still at the experimental stage.

• Vitamins - another important component of the treatment of alcoholic fetal syndrome. It's no secret that many neurological disorders are accompanied by an acute shortage of certain vitamins. Since not all useful substances are synthesized in the body, their deficiency must be compensated by the intake of special preparations:
  • Milgamma - a complex product containing an increased amount of vitamins gr. B, which allows normalize the disturbed function of the nervous system and stabilize the hematopoiesis;
  • Neuromultivitis - a combination of vitamins B1, B6, B12, contributing to the acceleration of metabolic processes in neural tissues;
  • L-carnitine is a natural preparation, in a sense an analog of the B vitamins. It is prescribed for atrophic processes in muscles, in psychomotor disorders.

Recently, doctors have noticed an improvement in dynamics after taking medication-correctors for intracellular metabolism. These are medications such as Tanakan, Mexidol, Ceraxon, which are prescribed concomitantly with vitamin therapy. This combination enhances antioxidant and nootropic abilities.

• Medications that improve cerebral circulation are prescribed to eliminate vasospasm, improve oxygen supply, and stabilize the state of nerve cells in the brain. The most common drugs are complex action:
  • Pikamilon (Picanoyl) is a nootropic preparation that has a sedative, stimulating, antioxidant effect. Not assigned to children under 3 years of age. Pikamilon is taken from 0.02 to 0.08 g to 3 times a day, for 1-2 months.
  • Fezam is a complex agent based on pyracetam and cinnarizine. Fezam eliminates cerebral hypoxia, dilates blood vessels and improves blood circulation. Do not use the drug to treat children under 5 years. The usual dosage is 1-2 capsules three times a day for 2 months. It is recommended to spend up to 3 courses of therapy per year. Caution: the drug may cause a sleep disorder.

In addition to the listed drugs, the following groups of drugs are possible:

• psychostimulants, which increase the physical and mental capabilities of a person (Pantogam, Cortexin);
• tranquilizers, which reduce unmotivated feelings of anxiety and anxiety (Chlordiazepoxide, Meprothan, Phenibut);
• muscle relaxants, lowering the excess muscle tone (Midokalm, Sirdalud).

Homeopathy is successfully used to correct psychoneurological disorders. Homeopathic remedies gently stimulate the protective-adaptive functions of the body, with virtually no side effects. For complex therapy, such medications are suitable:

• Cerebrum Compositum is a combined homeopathic remedy from the group of bioregulators of metabolic processes in the central nervous system. Assign 1 ampoule up to 3 times a week. The drug can be administered by all injection methods: subcutaneously, intradermally, intramuscularly and intravenously. Treatment in children is carried out only under the supervision of a doctor.
• Ubihinon Compositum is a homeopathic detoxification agent that corrects immunity and improves metabolism. The drug is injected. The standard single dose is 1 ampoule up to 2 times a week. Sometimes itching may occur at the injection site. Do not use the medicine during pregnancy.
• Traumeel C is a regenerating and immunomodulating agent that is used in the form of injections, 1-2 ampoules per day. There are also Traumeel tablets: they are kept in the mouth before resorption, from ½ to 3 tablets per day, depending on age and indications.
• Objective T - homeopathic remedy with anti-inflammatory and analgesic action. Adults and children after 6 years take the drug 1 tablet three times a day.
• Diskus Compositum - a remedy for the recovery of the nervous system. Single dose - 1 ampoule of the drug up to 3 times a week. It is not recommended for use in children under 6 years.

To stabilize the child's condition, one-sided treatment is usually not enough: a combination of techniques is needed, including exercise therapy sessions, manual therapy, kinesiotherapy and perceptive stimulation procedures, and psychological correction.

• To influence the defects of psycho-neurological development, children developed a special physiotherapeutic treatment, which is necessarily combined with exercise therapy.
  • thermal treatment is the action of heat, leading to vasodilatation, increased blood and lymph flow, and to the improvement of nutritional and recovery processes. Thermal treatment mainly involves the use of hot wraps (therapeutic mud, ozocerite, paraffin);
  • Cold treatment is the application of ice compresses to the areas of muscle spasm. Cold sessions often alternate with thermal procedures;
  • Water procedures, such as swimming in the pool, help to remove excess muscle tone, coordinate movements, teach the child to control his own body. Auxiliary useful property of swimming is hardening;
  • Water massage is a spectacular combination of hydrotherapy and massage. The procedure is carried out in warm water, which contributes to overall relaxation and pain reduction;
  • electrophoresis with medicinal products will help stabilize intracranial pressure, improve blood supply to tissues, and also have a sedative effect;
  • light therapy is a unique method of physiotherapy, which, thanks to infrared radiation, helps to eliminate pain, normalize thermoregulation, improve metabolism.
• Operative treatment allows you to eliminate such defects as heart disease, fusion of the anus, deformities of the limbs, etc. It is also possible to carry out operations on the brain and spinal cord. Surgical intervention in most cases helps restore the function of vital organs, and in some situations prolongs the child's life.

Alternative treatment of alcoholic fetal syndrome can complement the basic therapeutic regimen made up by the physician. Recipes of alternative medicine are used depending on the main symptoms and disorders found in the child.

• In case of impaired motor function, the following prescription can be used: insist 100 g of vinca grass in 0.5 l of vodka for 10 days, in the dark. Filter and give the child 3 drops before each main meal, pre-mixed in milk.
• With violations of the brain functions, we insist 30 g of the papilla seed and 20 g ruta in 0.5 liters of vodka for 10 days. We give the child using the diagram above.
• With insufficient mental development, this recipe is suitable: we mix 30 g of a drop cap, the same number of mint leaves and 20 g of thyme. We put one tablespoon of the collection in a thermos and pour half a cup of boiling water. After 2 hours, filter. The received infusion is divided into 2 parts, each of which the baby should drink for one day.
• To stabilize muscle activity, this tincture will help: 120 g of Sophora pour 0.5 liters of vodka and insist 10 days in the dark. We give the child 3 drops a day, mixed with milk.

Treatment with herbs can be done independently, coordinating their actions with a doctor. When designing the therapy, the following herbs or their mixtures can be used:

• wormwood - improves the work of the liver and digestive system, relieves pain in the head, soothes the nervous system;
• turn - used for taking baths and taking inside;
• Shepherd's bag - helps with urinary incontinence and supports the function of the limbs;
• rosehip - strengthens the defenses of the body, has an antisclerotic effect.

Psychocorrection in alcoholic fetus is a special role. A child with severe psychoneurological disorders is not easy to learn the surrounding space and establish communication. Therefore, the task of the therapist is to help the baby and stimulate his interest in learning. This can help such techniques:

• conductive pedagogy - teaching the child independence;
• music therapy - conducting music lessons for the all-round development of the baby.

On an individual basis, a physician selects a set of exercises for the development of motor function, to improve tactile and olfactory perception, to support the ability to communicate. We welcome the use of special educational computer games of varying degrees of complexity.

Prevention

Prevention is that a woman planning a pregnancy or already pregnant should refrain from taking any alcoholic beverages. Special drugs or vaccines that can prevent fetal alcohol syndrome of the fetus do not exist. Therefore, the soberness of the future mother is the main point of prevention.

It is wrong to hope that a complication can be prevented only by reducing the consumption of alcohol. It is proved that only absolute exclusion of alcoholic beverages is a guaranteed safety against illness.

Actually, preventive measures can be determined by the following tips:

• refuse the use of any alcoholic and low alcohol drinks, if you plan to conceive, are already pregnant, or simply not protected;
• Do not expect that this problem will not concern you: any dose of alcohol can be decisive;
• with chronic alcoholism it is important to undergo a full course of treatment in time, and only after the doctor's permission to plan a pregnancy.

[21], [22], [23],

Forecast

Children with intrauterine fetal syndrome usually lead a lifestyle different from that of ordinary children. Often, small patients are forced to learn and live in special institutions for special children, in neurological boarding schools, where they are handed over by careless parents. Patients with alcoholic syndrome in most cases are not adapted to independent life: their behavior can cause misunderstandings of others, and at an older age such people can suffer from alcoholism and other kinds of dependence.

Since alcoholic fetal syndrome is considered an incurable disease, its prognosis can not be called positive. However, the quality of life of a child largely depends on his family environment. If there is mutual understanding, patience and love in the family, then there is a hope that the baby can grow with fewer neuropsychiatric problems. Restoration of the affected nervous system does not occur in one day, so parents should be patient in order to achieve a lasting effect in treatment.

[24], [25], [26], [27]