19 Sep A 23-year-old woman presents to the OB-GYN office
A 23-year-old woman presents to the OB-GYN office you work in. She was recently surprised to learn that she is pregnant. She estimates that she is about 8 weeks along. She tells you that she regularly drinks on the weekends with her friends. She asks you, “Is that a problem? As long as I don’t drink very much, I can still have a drink occasionally while I’m pregnant, right?”In your initial post answer the following questions:I would first advise her to stop drinking alcohol since there is no evidence indicating a safe amount of alcohol for consumption during pregnancy. There is controversy associated with the volume of alcohol consumed and its effects so it’s best to not drink any alcohol (DeVido, Bogunovic, & Weiss, 2015). Alcohol is a lipid-soluble teratogen with a low molecular weight capable of readily crossing the placenta. Types of teratogenic agents include radiation, drugs or chemical substances,and infectious agents. A teratogen is an agent that can lead to abnormalities during embryonic development.It is considered a nongenetic, environmental factor.I would explain to her disorders caused by teratogenic andenvironmental factors and how they affect embryonic development. I would also educate her about multifactorial inheritance disorders and how alcohol consumption during pregnancy can increase its risk.Alcohol during pregnancy raises risks for abnormalities ranging from minor in severity to congenital disorders such as fetal alcohol syndrome (FAS). The woman is eight weeks pregnant which means her developing fetusis still in thehigh vulnerability period(Grossman& Porth,2013). This is the most sensitive time for development of birth defects because the embryo is undergoing rapid physiological changes (i.e. organogenesis). During the first eight weeks of life, the central nervous system, heart, extremities, eyes, and external genitalia are forming(Grossman & Porth, 2013). Alcohol consumption has been widely accepted as harmfulduring pregnancy. Abstaining onlyduring the periodof high vulnerability is not enough for preventing complications.Since organs like thefetal heart and brain are sensitive to the teratogenic effects of alcohol, I would recommend that she stop all alcohol consumption for the remainder of her pregnancy (Grossman& Porth,2013).According to Grossmanand Porth (2013), alcohol is lipid soluble and readily crosses theStudies reveal varying degrees of the effects of alcohol during pregnancy and its pathology thus giving rise to the term fetal alcohol spectrum disorders (FASD) (Wilhoit, Scott, &Simecka,2017).Birth defects manifest as neurological, cognitive and behavioral abnormalities that can occur along aearly in life and extend into adulthood (Wilhoit, Scott, &Simecka,2017). Alcohol consumption during pregnancy could cause low birth weight, preterm labor, and spontaneous abortions (DeVido, Bogunovic, & Weiss, 2015). Distinct facial attributes are seen in children with FAS such as microcephaly, flat nasal bridge, smooth philtrum, and a short nose(Grossman& Porth,2013). The prevalence of seizures is higher in individuals affected by FASD (Bell et al., 2010). It is speculated that because individuals with FASDare prone to epileptic seizures, they could also be at a higher risk for strokes (Cananzi&Mayhan, 2019).Since the pathogenesis of FAS is still being studied, I would stress that there are potentially unknown, long-term effects of drinking during pregnancy on the unborn child. There isresearch that suggestsin utero alcohol exposure in rats can increasesusceptibility of brain damage following cerebral ischemia in adulthood(Cananzi&Mayhan, 2019). ReferencesBell, S. H., Stade, B., Reynolds, J. N., Rasmussen, C., Andrew, G., Hwang, P. A., &Carlen, P. L. ( 2010) Theremarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders.Alcohol Clin Exp Res 34, 1084– 1089.Cananzi, S. G., &Mayhan, W. G. (2019). In utero exposure to alcohol impairs reactivity of cerebralarterioles and increases susceptibility of the brain to damage following ischemia/reperfusionin adulthood. Alcoholism: Clinical & Experimental Research, 43(4), 607–616.https://doi-org.ezproxy.bradley.edu/10.1111/acer.13979DeVido, J., Bogunovic, O., & Weiss, R. D. (2015). Alcohol use disorders in pregnancy. Harvard review of psychiatry, 23(2), 112–121. doi:10.1097/HRP.0000000000000070Grossman, S. & Porth, C.M. (2013). Porth’s pathophysiology: Concepts of altered health states (9th ed.).Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN: 978-1451146004Wilhoit, L., Scott, D., &Simecka, B. (2017). Fetal alcohol apectrum disorders: Characteristics,complications, and treatment. Community Mental Health Journal, 53(6), 711–718.https://doi-org.ezproxy.bradley.edu/10.1007/s10597-017-0104-0
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