Teratogenesis

teratology-Teratogenesis-Birth defect-Congenital malformation- anomaly(Hereditary) abnormality

Transcript

3. Birth defect Congenital malformation Congenital anomaly (Hereditary) abnormality
4. • Malformation • Disruptions • Deformations • Syndromes • Minor anomalies • Major anomalies
5. 1 - خساپ ( یزیذپ بیسآ ) نژًتازت لماع هب ردام ي هیىج 2 - هیىج یلماکت هلحزم (Developmental stage at the time of exposure) 3 - نژًتازت لماع اب سامت نامس تدم ي سيد (Dose and duration of exposure to a teratogen) 4 - نژًتازت لمع هقیزط : یلًکلًم ي یلًلس حطس رد تازییغت 5 - نژًتازت هجیتو : یدزکلمع یاه یرامیب ،دشر یگدوام بقع ،یراجىهاو ،گزم
6.  Hereditary (Genetic) causes 15-18%  Environmental factors 7-10%  Multifactorial 25%  Unknown 50%
7.  First week (Resistant period)  Embryonic period  Maximum susceptibility (organ morphogenesis)  Fetal Period  Lowered Susceptibility (functional derangement)
8. • 1 - تالالتخا موزومورك يدادعت ( Numerical Chromosomal Anomalies ) • فلا ) يلپ یديئولپ ( Polyploidy ) Triploidy 69 کي اب ديئولپيد کمخت اي مرپسا ود اب ديئولپاه كمخت كي مرپسا Tetraploidy 92 ژاويلك نيلوا • ب ) یديئولپونآ ( Aneuploidy ) یموزيرت يموزيرت 13 (Patau syndrome) یموزيرت 18 ( Edwards syndrome ) یموزیرت 21 مردنس نواد ( Down syndrome ) رتلف نیالك مردنس ( Klinfelter syndrome-XXY ) Triple X (Superfemale) یمزونوم رنرت مردنس ( Turner syndrome- XO )
9. Patau Syndrome 1/20000 cleft-lip-baby
10. Edwards Syndrome 1/5000
11. Maternal nondisjunction (95%) Mosaism Translocation
12. •Monosomy •Nondisjunction in sperm 80% •Struc X •Nondisjunction in mitosis (Mosaism)
13. • 2 - موزومورك ينامتخاس ياه يراجنهان • ( Structural Chromosomal Anomalies ) • Isochromosome • Crossing over : • Translocation 21,13,14, 15 in Down syndrome • Partial Deletion Cri du chat 5(microcephal, mental, cardiovas) • Microdeletion Angelman 15 (speech, mental, movement) Prader- willi 15 (fatty, mental, hypogonad) • Inversion
14. • 3 - ياه يراجنهان ينژ شهج زا لصاح ( Gene Mutation Anomalies ) • Marphan syndrome • Crigler-Najjar syndrome • Roberts syndrome • Alport syndrome • Aarskog-Scott syndrome • Savant syndrome • treacher-collins syndrome • Niemann–Pick disease • Cystic Fibrosis • DMD
15. • Infectious Agents (& other disease) • Drugs Agents (& Hormonic Agents) • Chemical Agents • Physical Agents
16. • A) Viral infections • Rubella virus (German Measles) هجخرس سوریو 1month-From placenta- atrioventricular septsl defect, cataract. Weight • Cytomegalovirus(CMV) From Placenta,Cervix,Vagina (& Lactation) - microephaly, deafness, mental retardation, hepatospleenomegally ,cardiac defect,cerebral calcification, blue spot on skin • Herpes simplex virus(HSV) From Placenta,Vagina(85%)- Defect in CNS,liver, pancreas,ren,suprarenal glands, infection on skin, Eyes or mouth – no treatment=40-50% death • Varicella-zoster virus(VZV) ناغرم هلبآ First 3 month-From Placenta- limb hypoplasia & parasis., hydrocephaly. Mental retardation, cataract • HIV After 35th week- Systematic Chronic infection(fangus,bacterial,viral,protozoan)
17. • B) Nonviral infections •Toxoplasma in each three munth - death,microcephaly,hydroceohaly,cerebral calcification •Treponema pallidum Syphilis, rhinitis,eye defect(cataract),icterus,abnormal teeth, splenohepatomegaly
18. • Desease •Diabetes Coudal disgenesis, death •PKU mental retardation, microcephaly, cardiac defect • Nutrient deficiency Iodine deficiency coused cretinism • Obesity ONTD, cardiac defect, … • Hypoxy
19. Drugs Agents Category X drugs Category D drugs
20. Category X drugs  Thalidomide  Aminopterin  methotrexate  Busulfan  Phenytoin  Triazolam  Warfarin  Isotretinoin Clomiphen Diethylstilbestrol Ethisterone Norethindrone Nicotine Alcohol
21. Category X drugs  Thalidomide    
22. Category X drugs  Thalidomide
23. Category X drugs Aminopterin Methotrexate Busulfan  Used in chemotererapy  Dawerfism  Myelomeningocele  palate clef  Growth retardation  ophtalmic defect
24. Category X drugs Aminopterin Methotrexate Busulfan  Used in chemotererapy  Dawerfism  Myelomeningocele  palate clef  Growth retardation  ophtalmic defect
25. Category X drugs Phenytoin Antileptic drug microcephaly Growth & mental retardation palate clef Finger & nail Hypoplesia Skull defect
26. Category X drugs Warfarin Anti couagulant drug  Mental retardation  microcephaly  optic n. atrophy  Fetal bleeding
27. Category X drugs Clomiphen Non-steroidal drug Used for stimulus ovulation Maybe Malformatin
28. Category X drugs Retinoids (vitamin A) Used for Cystic akne severe craniofacial defects  cardiac defects neural tube defects (NTD) Palate cleft tretinoin (Retin-A) isotretinoin, 13-cis-retinoic acid
29. Category X drugs Nicotine  Mental retardation  Wheight loss  Fetal Hypoxy  Premature Parturition
30. Category X drugs Alcohol  Fetal Alcholic Syndrome (FAS)  Mental retardation  microcephaly  Cardivascular defect  Limb & Face malformation  Hairsutism
31. Category D drugs  Tetracycline  doxycycline  Streptomycin  Phenobarbital  Pentobarbital  Valsuroic acid  Diazepam  lorazepam  Lithium  Hydrochlorothiazide
32. Category D drugs  Phenobarbital & Pentobarbital  paliative drug  Fetal malformation
33. Category D drugs Diazepam, Lorazepam , Chlorodiazepoxide  antianxiety drug  palate & lip clef specially in first 3 munth
34. Category D drugs Lithium ,Phenothiazine Antiedepressive CardioVascular defect
36. Physical Agents
37. Male-mediated Teratogenesis  Chromosomal defects & Mutation in germ cells  Environmental agent : transmission of paternal mediated toxicity through seminal fluid
38.  Ultrasonography  Maternal Serum Screening (AFP,hCG) AFP : Trisomy NTD,GIT atresia,amniotic band  Amniocentesis  Chorionic Villus Sampling (CVS)
39.  Fetal Transfusion  Fetal Medical Treatment  Fetal Surgery  Stem Cell Transplantation and Gene Therapy Befor 18th week (activation of immune system)