Fetal alcohol syndrome

There is a medical term called fetal alcohol syndrome - it is a collective term meaning certain deviations in the development of the baby. Moreover, such deviations can be both physical and mental. The reason for this phenomenon is the intake of alcoholic beverages by the expectant mother.

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.

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Causes fetal alcohol syndrome

The first mention of fetal alcohol syndrome was recorded in the 19th century by a French scientist who studied the relationship between maternal alcoholism and the child's developmental delays. The symptoms collected and identified were later combined into a syndrome called alcoholic or fetal.

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

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Pathogenesis

The pathogenesis of fetal alcohol syndrome can be described as follows:

• when a woman drinks alcohol, ethyl alcohol easily passes through the placenta to the growing fetus;
• the level of ethyl alcohol in the blood of a developing baby is higher than its amount in the woman's bloodstream, since the fetus's liver neutralizes ethanol more slowly than it does in an adult body;
• Ethyl alcohol inhibits the transfer of oxygen and nutrients to tissues, including the fetal brain.

The more often and the more alcoholic drinks the expectant mother drinks, the more likely it is that the child will develop disorders.

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Symptoms fetal alcohol syndrome

The first signs of fetal alcohol syndrome appear immediately after the baby is born and are physical and mental abnormalities. Such disorders do not go away on their own and remain with a person for life.

Fetal alcohol syndrome is primarily manifested by mental deficiencies - these can be nervous disorders, mental retardation, behavioral characteristics, intellectual retardation, dissonance of brain functions. As the child grows, a lag in body weight and growth becomes noticeable: however, sometimes this is noticeable at the birth of the baby. Often, such children are born prematurely or have a low body weight.

There are also external differences between children:

• shortening of the eye slits, possibly strabismus;
• narrow forehead, underdeveloped chin;
• inexpressiveness of the nasolabial philtrum;
• thinning of the upper lip;
• drooping eyelids;
• microcephaly;
• signs of blepharophimosis.

External signs remain with a person forever, so a diagnosis of fetal alcohol syndrome can be made regardless of age.

Among the internal anomalies, the most frequently detected are heart valve defects, vascular development defects, adhesion of the anus, deformations of the skeletal system, and short limbs.

Often children have problems with visual and auditory functions, they are slow (the so-called slow-witted). In educational institutions, it is difficult for them to keep up with other children: they have a bad memory, sometimes they are unable to control their emotions and mood. Due to the difficulty of adaptation, it is recommended to send such children to special schools.

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Complications and consequences

• A child suffering from 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 overly emotional, irritable, and has difficulty concentrating and remembering any information.
• Often, especially in adolescence, a child cannot establish contact with classmates, it is difficult for him to communicate with teachers. Conflict with others gradually increases, and over time can lead to crimes.
• There is a very high probability of developing an addiction to alcohol.
• Possible reproductive dysfunction in the future.

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Diagnostics fetal alcohol syndrome

The diagnosis of fetal alcohol syndrome can be established based on anamnestic data, information about the peculiarities of the course of pregnancy and labor. The condition of the baby after birth and its assessment on the Apgar scale are also taken into account.

As a child grows up, attention is paid to the dynamics of his development, to the parameters of his height and weight.

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Differential diagnosis

Differential diagnostics is usually difficult, since this pathology does not have any specific symptoms, and it is easy to confuse it with other psychoneurological deviations. To confirm the diagnosis, it is important to exclude consanguinity of the parents.

Instrumental diagnostics involves the use of the following methods:

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

In particular, EEG can reveal significant synchronization of the child's sleep rhythm and other disorders.

Laboratory diagnostic methods include tests for ethanol, carboxyhemoglobin, and nicotine in the pregnant woman's bloodstream and in blood taken from the umbilical cord. Less relevant are chromosome tests and serum enzyme assessments.

Treatment fetal alcohol syndrome

Unfortunately, it is not possible to cure fetal alcohol syndrome, since defects and malfunctions in the organs are already laid down during the period of intrauterine growth of the baby. However, treatment is still necessary: it is often aimed at alleviating the symptoms of the disease and even prolonging the life of the patient.

Thus, if necessary, operations are performed to correct heart valves or the digestive tract. In addition, the child should be registered with a neurologist and, in older age, regularly attend psychologist sessions. All this will help guide the child's behavior and facilitate his social adaptation.

The possibility of alleviating the course of the pathology is based on the characteristics of the child’s body and the degree of damage to his nervous system.

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

For this purpose, neurology often uses biostimulants that are capable of restoring neuron functions, improving oxygen exchange and nutrition in nerve cells. We present 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 an amount of 3.3 g per day, depending on the indications. The drug should not be taken if the child is under 1 year old.
• Encephabol is used for mental retardation, cerebroasthenia, encephalopathy, oligophrenia, and exogenous intoxications. The drug is not prescribed to children under 7 years of age. Method of administration - orally, 1-2 tablets up to 3 times a day. The course of treatment is at least 2 months.
• Pantogam is prescribed for organic disorders in the brain, as well as for neurotic disorders. Pantogam is not recommended for use by people under 18 years of age. The drug is taken orally, 20 minutes after meals, 1-4 capsules up to 3 times a day. The duration of treatment is determined by the doctor and can last for several months in a row.
• Semax is a synthetic analogue of corticotropin, which has a pronounced effect on the processes of memorization, learning and adaptation. The drug is used as nasal drops, 3 drops in each nasal passage, up to 3-4 times a day. Contraindications include allergies, pregnancy and breastfeeding.
• Neuromidin is a cholinesterase inhibitor. It improves the transmission and conductivity of nerve impulses, facilitates the process of memorization. Neuromidin is not prescribed for gastrointestinal diseases, cardiac pathologies, and in childhood. The dosage regimen is ½ or 1 tablet up to 3 times a day. Duration of therapy is up to 2 months.

Stimulation of the functional capacity of nerve cells, restoration of the conduction of nerve impulses and the formation of nerve connections is achieved through the use of ganglioside drugs such as Cronassial and Biosynax.

Hydrolysate preparations are also widely used, reducing oxygen starvation of the brain and strengthening neurons. The most common representative of hydrolysates is Cerebrolysin.

The above types of drug treatment for fetal alcohol syndrome are aimed at compensating for psychoneurological disorders by restoring damaged nerve cells. But it should be noted that the general lack of neurons cannot be compensated for, so a complete cure is an unrealistic issue.

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

• Vitamins are another important component of fetal alcohol syndrome treatment. It is no secret that many neurological disorders are accompanied by an acute deficiency of certain vitamins. Since not all useful substances are synthesized in the body, their deficiency has to be compensated for by taking special medications:
  • Milgamma is a complex remedy containing an increased amount of B vitamins, which helps to normalize the impaired function of the nervous system and stabilize hematopoiesis;
  • Neuromultivit is a combination of vitamins B1, B6, B12, which helps to accelerate metabolic processes in nerve tissues;
  • L-carnitine is a natural preparation, in a certain sense an analogue of B vitamins. It is prescribed for atrophic processes in muscles and psychomotor disorders.

Recently, doctors have noticed an improvement in the dynamics after taking drugs that correct intracellular metabolism. These are medications such as Tanakan, Mexidol, Ceraxon, which are prescribed simultaneously with vitamin therapy. This combination mutually enhances antioxidant and nootropic abilities.

• Medicines that improve cerebral circulation are prescribed to eliminate vascular spasms, improve oxygen supply, and stabilize the state of the brain's nerve cells. The most common drugs are those with a complex effect:
  • Picamilon (Picanoil) is a nootropic drug that has a calming, stimulating, antioxidant effect. It is not prescribed to children under 3 years of age. Picamilon is taken from 0.02 to 0.08 g up to 3 times a day, for 1-2 months.
  • Fezam is a complex remedy based on piracetam and cinnarizine. Fezam eliminates cerebral hypoxia, dilates blood vessels and improves blood circulation. The drug should not be used to treat children under 5 years of age. The usual dosage is 1-2 capsules three times a day for 2 months. It is recommended to conduct up to 3 courses of therapy per year. Caution: the drug may cause sleep disorders.

In addition to the listed medications, the following groups of drugs may be prescribed:

• psychostimulants that enhance a person’s physical and mental capabilities (Pantogam, Cortexin);
• tranquilizers that reduce unmotivated feelings of anxiety and restlessness (Chlordiazepoxide, Meprotan, Phenibut);
• muscle relaxants that reduce excessive muscle tone (Mydocalm, Sirdalud).

Homeopathy is successfully used to correct psychoneurological disorders. Homeopathic preparations gently stimulate the protective and adaptive functions of the body, with virtually no side effects. The following medications are suitable for complex therapy:

• Cerebrum Compositum is a combined homeopathic remedy from the group of bioregulators of metabolic processes in the central nervous system. Prescribed 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.
• Ubiquinone Compositum is a homeopathic detoxifying agent that corrects immunity and improves metabolism. The drug is administered by injection. The standard single dose is 1 ampoule up to 2 times a week. Sometimes there may be a feeling of itching at the injection site. Do not use the drug during pregnancy.
• Traumeel C is a regenerating and immunomodulatory 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 until dissolved, from ½ to 3 tablets per day, depending on age and indications.
• Tsely T is a homeopathic remedy with anti-inflammatory and analgesic action. Adults and children over 6 years old take the drug 1 tablet three times a day.
• Discus Compositum is a remedy for restoring the nervous system. Single dosage is 1 ampoule of the drug up to 3 times a week. Not recommended for use in children under 6 years of age.

To stabilize the child’s condition, unilateral treatment is usually not enough: a combination of methods is required, including exercise therapy sessions, manual therapy, kinesiotherapy and perceptive stimulation procedures, as well as psychological correction.

• To influence the defects of psychoneurological development in children, a special physiotherapeutic treatment has been developed, which is necessarily combined with exercise therapy.
  • Thermal treatment is the effect of heat, which leads to the expansion of blood vessels, increased blood and lymph flow, and also to the improvement of nutritional and restorative processes. Thermal treatment mainly involves the use of hot wraps (therapeutic mud, ozokerite, paraffin);
  • Cold therapy is the application of ice packs to areas of muscle spasm. Cold sessions are often alternated with heat treatments;
  • water procedures, such as swimming in a pool, help relieve excess muscle tone, coordinate movements, and teach a child to control his own body. An additional useful property of swimming is hardening;
  • water massage is an effective combination of hydrotherapy and massage. The procedure is carried out in heated water, which promotes general relaxation and pain relief;
  • electrophoresis with medications will help stabilize intracranial pressure, improve tissue blood supply, and also have a sedative effect;
  • Light therapy is a unique physiotherapy technique that, thanks to infrared radiation, helps eliminate pain, normalize thermoregulation, and improve metabolism.
• Surgical treatment allows to eliminate such defects as heart defects, adhesions of the anus, limb deformities, etc. It is also possible to perform operations on the brain and spinal cord. Surgical intervention in most cases helps to restore the function of vital organs, and in some situations prolongs the child's life.

Folk treatment of fetal alcohol syndrome can complement the main therapeutic scheme drawn up by the doctor. Folk medicine recipes are used depending on the main symptoms and disorders found in the child.

• In case of impaired motor function, you can use the following recipe: infuse 100 g of periwinkle herb in 0.5 l of vodka for 10 days, in the dark. Strain and give the child 3 drops before each main meal, after mixing it in milk.
• For disorders of brain functions, infuse 30 g of eryngium seed and 20 g of rue in 0.5 l of vodka for 10 days. Give to the child using the scheme above.
• If the child has insufficient mental development, the following recipe will do: mix 30 g of betony, the same amount of mint leaves and 20 g of thyme. Put one tablespoon of the mixture in a thermos and pour half a glass of boiling water over it. Filter after 2 hours. The resulting infusion is divided into 2 parts, each of which the child should drink throughout the day.
• To stabilize muscle activity, this tincture will help: pour 120 g of sophora with 0.5 l of vodka and leave for 10 days in the dark. Give the child 3 drops three times a day, after mixing with milk.

Herbal treatment can be done independently, after consulting with your doctor. When creating a treatment plan, you can use the following herbs or their mixtures:

• wormwood - improves liver and digestive system function, relieves headaches, calms the nervous system;
• succession - used for baths and internal use;
• Shepherd's purse - helps with urinary incontinence and supports limb function;
• Rose hips – strengthens the body’s defenses, has an anti-sclerotic effect.

Psychocorrection in fetal alcohol syndrome has a special role. It is not easy for a child with severe psychoneurological disorders to master the surrounding space and establish communication. Therefore, the task of the psychotherapist is to help the child and stimulate his interest in learning. The following methods can help with this:

• conductive pedagogy – teaching a child independence;
• music therapy – conducting music lessons for the comprehensive development of the child.

On an individual basis, the doctor selects a set of activities to develop motor function, to improve tactile and olfactory perception, to support the ability to communicate. The use of special educational computer games of varying degrees of complexity is encouraged.

Prevention

Prevention consists of the fact that a woman planning a pregnancy or already pregnant should abstain from drinking any alcoholic beverages. There are no special medications or vaccines that can prevent fetal alcohol syndrome. Therefore, the sobriety of the expectant mother is the main point of prevention.

It is wrong to hope that complications can be prevented only by reducing alcohol consumption. It has been proven that only the absolute exclusion of alcoholic beverages is a guaranteed safety from the disease.

In fact, preventive measures can be defined by the following tips:

• Avoid drinking any alcoholic or low-alcohol beverages if you are planning to conceive, are already pregnant, or simply do not use protection;
• don't expect that this problem won't affect you: any dose of alcohol can be decisive;
• In case of chronic alcoholism, it is important to undergo a full course of treatment in a timely manner, and only after the doctor’s permission to plan a pregnancy.

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Forecast

Children with intrauterine fetal syndrome usually lead a lifestyle that differs from that of normal children. Often, young patients are forced to study and live in special institutions for special children, in neurological boarding schools, where they are sent by negligent parents. Patients with alcohol syndrome in the overwhelming majority of cases are not adapted to independent life: their behavior can cause misunderstanding among others, and in older age, such people can suffer from alcoholism and other types of addiction.

Since fetal alcohol syndrome is considered an incurable disease, its prognosis can no longer 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 hope that the baby will be able to grow up with fewer psychoneurological problems. The restoration of the affected nervous system does not happen in one day, so parents must be patient to achieve a lasting effect in treatment.

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