Fetal alcohol syndrome

Introduction

The fetal alcohol syndrome belongs to the so-called embryo fetopathies. It is a group of diseases characterized by damage or malformation of the unborn child during pregnancy. In Germany, it is also the most common reason for a mental disability. Approximately every thousandth child is born in Germany with the signs of fetal alcohol syndrome. Typical for FAS is a characteristic facial shape, which will be discussed in more detail in a separate section.

Causes of fetal alcohol syndrome

As the name of the syndrome suggests, FAS is caused by maternal alcohol consumption during pregnancy. A rough rule of thumb is that the earlier in pregnancy the alcohol is consumed, the worse the effects are for the unborn child. A value below which the consumption of alcohol is not dangerous for the child could not be determined at present yet. In the worst case the consumption of alcohol leads to the so-called fruit death, thus the dying of the unborn child in the womb.

Diagnosis of fetal alcohol syndrome

The diagnosis of fetal alcohol syndrome is based on a few clues and can usually only be made with great certainty during childhood. A distinction is also made between full-blown FAS and first- or second-degree fetal alcohol syndrome, depending on how pronounced the syndrome is. The full-blown syndrome includes, on the one hand, proven alcohol consumption by the mother during pregnancy and, on the other hand, a reduction in growth, damage to the central nervous system – culminating in mental retardation – and the presence of a facial shape typical of FAS. Mental retardation usually only becomes apparent during the first years of life and should be a warning to any pediatrician.

Associated symptoms of fetal alcohol syndrome

Children with fetal alcohol syndrome have many other symptoms besides mental impairment. Bone deformities can occur, such as fusing of the forearm bones, malpositioning of the jaw or a so-called connective tissue weakness. Children suffer from slack joint ligaments and show a changed, often laxer skin appearance.

Furthermore, their overall growth is restricted. They suffer from short stature and often have a small skull at birth. Other affected areas can be almost all internal organs.

As a rule, FAS is associated with a heart defect. In over 90% of cases, this is a ventricular septal defect, i.e. a pathological connection between the two chambers of the heart. In addition, the urinary and sexual apparatus of these children is often not properly developed.

This can affect the external genitals as well as the kidneys and ureters. In addition to mental retardation, there are frequent seizures, a reduced sense of pain and general sensitivity problems, which in turn suggest damage to the central nervous system. As already mentioned in the upper sections, a pronounced fetal alcohol syndrome is mainly visible on the child’s face.

Noticeable are the narrow lips of these children. This affects both the upper and lower lip. The chin is displaced backwards; the medical profession refers to this circumstance as a receding chin, since the connection from lip to chin runs continuously backwards in the profile view.

Affected children also stand out because the distance between the eyes is perceived as too great. The eyelid axis of the eyes is not straight, but usually such that the outer corner of the eye is lower than the middle corner. The upper attachment point of the ears slides below the level of a lid axis extended backwards.

This circumstance becomes particularly clear in the profile view. Furthermore, the ears appear slightly rotated backwards, as if the upper pole of the ears had been pulled backwards. Further very conspicuous characteristic is the no longer existing “Philtrum”; colloquially also called Rotzrinne.

The connection between nose and upper lip of the FAS is therefore usually flat, without elevations. Last but not least, and no longer completely belonging to the face, affected children show a narrow forehead as well as an altogether too small head.The descriptions given here are full versions and can be only partially or not at all pronounced in the case of affected persons. Children suffering from fetal alcohol syndrome are generally considered to be particularly restless, agitated and restless.

They usually find it difficult to remain still or concentrate on one thing for a long time. In later childhood they are often described by their peers as pushy, aloof or simply “funny”. In addition, these children also stand out with learning difficulties.

They find it difficult to remember instructions or facts and therefore often appear lazy or disorganized in their environment. A causal treatment of the disease is no longer possible after its manifestation. In order to prevent the syndrome from occurring, the mother would have to completely stop drinking alcohol during pregnancy.

With the help of modern medicine, only some of the symptoms that have occurred can be corrected. The frequently occurring heart defects can be treated by means of surgical interventions. Hearing impairment or eye defects can be corrected with hearing aids, cochlear implants and glasses or contact lenses.

However, mental retardation of the affected children cannot be treated. These children can only be supported in their development in the best possible way through the use of speech therapy, physiotherapy and occupational therapy. The developmental deficits can thus be compensated to a small extent.

Psychotherapeutic care of the children is also often recommended in order to be able to cope better with the experiences of an alcoholic parent during their upbringing. However, one should refrain from a careless treatment like a child suffering from ADHD. Although the FAS is also associated with ADHD in some cases, fetal alcohol syndrome and ADHD are not considered the same. If you would like information on this topic, we recommend our pages:

  • Attention Deficit Hyperactivity Syndrome
  • Recognizing hearing loss in children- Can my child hear properly?