Nov 06, 2017 in 1975, hanson and smith identified special clusters of anomalies, including craniofacial features, microcephalus, mental retardation and hypoplasia of the distal phalanges in the offspring of women taking phenytoin, and they proposed calling these specific phenytoinrelated anomalies fetal hydantoin syndrome see table 1. Tinu syndrome with concomitant synovitis rheumatology case report. Treatment is directed towards the symptoms that are present in an individual. A case of prenatal diagnosis of fetal hydantoin syndrome. Handbook of genetic counselingfetal hydantoin syndrome.
The abnormalities found in children with fetal hydantoin syndrome. Fetal hydantoin syndrome definition of fetal hydantoin. The trip database provides clinical publications about. Fetal hydantoin syndrome how is fetal hydantoin syndrome. Use of phenytoin in pregnancy for epileptic seizure prevention. Control seizure activity without severe adrstherapy must be individualizedmonotherapy is ideal but combination therapy may be necessary. In this case, the patient did not represent the full picture of the syndrome. The facial features of fetal alcohol syndrome can be seen in both a child and a mouse fetus that were exposed to alcohol during development. The fetal hydantoin syndrome refers to a spectrum of features that can develop in a small proportion 10% 5 of women taking the antiepileptic drug phenytoin dilantintm during pregnancy. Please see the terms and conditions this page was written by scott moses, md. A case of prenatal diagnosis of fetal hydantoin syndrome by. Dec 07, 2011 risks associated with fetal hydantoin syndrome. A case of prenatal diagnosis of fetal hydantoin syndrome by ultrasound thomaz rafael gollop and ivan salzo abstract fetal hydantoin syndrome fhs is a set of disruptions occasionally present in fetuses exposed in utero to phenytoin or other anticonvulsants. Fetal hydantoin syndrome and its anaesthetic implications.
Fetal hydantoin syndrome or fetal dilantin syndrome is a rare disease that is caused when a fetus is exposed to phenytoin, an anticonvulsant drug in the form of dilantin. What is the abbreviation for fetal hydantoin syndrome. Fetal hydantoin syndrome is a characteristic pattern of mental and physical birth defects syndtome results from maternal use of the antiseizure anticonvulsant drug phenytoin dilantin during pregnancy. In 1975, hanson and smith identified special clusters of anomalies, including craniofacial features, microcephalus, mental retardation and hypoplasia of the distal phalanges in the offspring of women taking phenytoin, and they proposed calling these specific phenytoinrelated anomalies fetal hydantoin syndrome see table 1. Clinical presentation cns anomalies microcephaly i.
The fetal hydantoin syndrome, a recurrent pattern of minor anomalies that occurs in about 10% of infants born to epileptic women treated with phenytoin during pregnancy, has been recognized for more than 35 years 233. Carbamazepine, which is used as treatment for epilepsy and bipolar. Fetal alcohol syndrome and fetal hydantoin syndrome 22 as well as prematurity and perinatal hypoxia are risk factors for infantile esotropia. A pattern of fetal anomalies associated with hydantoin, of which phenytoin is a derivative, was first described in the literature in 1975. There have been several reported cases of malignancies, including neuroblastoma, in children whose mothers received phenytoin during pregnancy. Ideal sources for wikipedia s health content are defined in the guideline wikipedia. Know the causes, symptoms, treatment and diagnosis of fetal hydantoin syndrome. An additional 30% of children who are exposed during embryonic development show lesser degrees of alteration. Fetal hydantoin syndrome is a disorder that is caused by exposure of a fetus to phenytoin, a drug commonly prescribed for epilepsy. Fetal hydantoin syndrome symptoms,causes,treatment and. The types of malformations that can result in fetuses exposed to aeds. Aug 10, 2011 fetal hydantoin syndrome is a disorder that is caused by exposure of a fetus to phenytoin, a drug commonly prescribed for epilepsy. Women taking dilantin for the treatment of epilepsy runs the risk of delivering a child who is 2 to 3 times more prone to suffer from congenital defects.
The discussion aims to bring to attention thepotential hazard of the use of hydantoin drug during reproductive age to all medical practitioners. Fetal hydantoin syndrome, neuroblastoma, and hemorrhagic. Fetal hydantoin syndrome pictures, causes, symptoms. Some of the principal syndromes of this disorder include microcephaly or developing an unusually small head, brain malfunctions, developmental delays, growth deficiencies. Symptoms in affected individuals may include abnormalities of the skull and facial features, growth deficiencies, underdeveloped nails of the fingers and toes, andor mild developmental. An anticonvulsant drug, c15h12n2o2, used to treat epilepsy, often in the form of its sodium salt.
Mar 06, 2020 fetal hydantoin syndrome is a rare medical condition in which a developing fetus is exposed to a seizure medication known as phenytoin. Discussion this case report illustrates the musculoskeletal anomalies seen in fetal hydantoin syndrome. Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. In the 70 years since the introduction of the first anticonvulsant, phenobarbital, a large and diverse group of drugs has been developed to control seizures. Fhs fetal hydantoin syndrome 710% with phenytoin generally associated with variety of craniofacial defects as well as hypoplasia of the distal phalanges and small or absent fingernails may be due to decreased levels of epoxide hydrolase, an enzyme which increases the clearance of some potentially toxic metabolites epoxides. Fetal hydantoin syndrome is also known as fetal dilantin syndrome which refers to the combination of defects that is caused to the development of the fetus, which is due to the side effects of phenytoin pht which is an antiseizure medication, the medicine helps in prevention of tonicclonic seizures. Dilantin, phenytoin and a few other similar anticonvulsants are also included. Fetal hydantoin syndrome symptoms,causes,treatment and more. Symptoms, risk factors and treatments of fetal hydantoin syndrome medical condition fetal hydantoin syndrome, also called fetal dilantin syndrome is a group of. Not all infants exposed to phenytoin will be affected with the disorder. Prenatal prediction of risk of the fetal hydantoin syndrome.
Of infants born to women who used phenytoin during pregnancy, 1030% are reported to show some of the characteristics associated with this syndrome. The neuroblastoma, a neural crest tumor, is the fourth of such origin reported after in utero exposure to phenytoin, suggesting that phenytoin is a transplacental carcinogen. Fetal hydantoin syndrome genetic and rare diseases. In the rat model of fetal hydantoin syndrome, litters with cl fetuses were always. November 1982 816 the journal of p e d i a t r i c s fetal hydantoin syndrome. Drug is thought to deplete already low levels of fetal vitamin k therefore suppressing the vitamin kdependent coagulation factors ii, vii, ix, and x. A drugrelated embryofetopathy that can occur when an embryofetus is exposed to the anticonvulsant drug. Fhs abbreviation stands for fetal hydantoin syndrome. Hypoplastic distal phalanges and fingernails are common features. The risk that an infant exposed to hydantoin in utero will have the clinical phenotype of the fullblown fetal hydantoin syndrome is approximately 5 to 10 percent, whereas the risk of an infants. Fetal hydantoin syndrome radiology reference article.
Sibs exposed to similar amount have been affected to different degrees. The medical acronym abbreviationslang fhs means fetal hydantoin syndrome. Organ damage, especially involving the circulatory and digestive systems, may be present in more severe cases of. Fetal hydantoin syndrome with rheumatic valvular heart disease.
Fetal hydantoin syndrome affects males and females in equal numbers. About europe pmc funders joining europe pmc governance roadmap outreach. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pdf there has been considerable debate about the relationship between epilepsy. Fetal hydantoin syndrome fhs is a spectrum of defects caused to the developing fetus by exposure to the teratogenic effects of antiepileptic drug aed phenytoin during pregnancy. Click on the image or right click to open the source website. Fetal hydantoin syndrome, also called fetal dilantin syndrome is a group of defects caused to the developing fetus by exposure to the teratogenic effects of phenytoin or carbamazepine.
The code is valid for the year 2020 for the submission of hipaacovered transactions. Fetal hydantoin syndrome, also called fetal dilantin syndrome is a group of defects caused to the developing fetus by exposure to teratogenic effects of phenytoin. Further studies are recommended to combine phenytoin with other antivitiligo. Fetal hydantoin syndrome is associated with maternal. This page was last revised on 10212007 and last published on 152020. These images are a random sampling from a bing search on the term fetal hydantoin syndrome. Mar 30, 2020 a pattern of fetal anomalies associated with hydantoin, of which phenytoin is a derivative, was first described in the literature in 1975. Fetal hydantoin syndrome is a rare medical condition in which a developing fetus is exposed to a seizure medication known as phenytoin.
Phenytoin is linked to a hypersensitivity syndrome manifested by fever, rash. Fetal hydantoin syndrome nord national organization for. There is a wide range in the nature and severity of characteristics associated with fetal hydantoin syndrome. Fetal hydantoin syndrome pictures, causes, symptoms, diagnosis. Fetal hydantoin syndrome is by far the bestcharacterized malformation complexes induced by anticonvulsant drugs used to treat maternal epilepsy. Dilantin is the brand name of the drug phenytoin sodium in the united states, commonly used in the treatment of epilepsy. Anticonvulsants, hydantoin drug information, professional. Phenytoin diphenylhydantoin or dilantin is anticonvulsant agent used in the treatment epilepsy. Dilantin is the brand name of the drug phenytoin sodium in the united states, commonly used in.
Reported abnormalities include cleft lip, cleft palate, heart malformations, and the fetal hydantoin syndrome also known as the fetal anticonvulsant syndrome and characterized by prenatal growth deficiency, microcephaly, craniofacial abnormalities, hypoplasia of the fingernails, and mental deficiency associated with intrauterine. Studies have suggested that approximately 5%10% of infants exposed to phenytoin during pregnancy will develop fetal hydantoin syndrome. Fetal hydantoin syndrome medical condition youtube. The biological basis of fetal alcohol syndrome and other alcoholrelated birth defects. Pregnancy merges previous categories of pregnancy and labor and delivery. But most antiepileptic drugs, such as phenytoin has a teratogenic effect, means these drugs can cross placental barrier of the pregnant women and reach to the fetus or embryo and provide multiple harmful effects like fetal hydantoin syndrome. Nov 06, 2017 discussion this case report illustrates the musculoskeletal anomalies seen in fetal hydantoin syndrome. Of these diseases, those characterized by structural deformities are termed congenital anomalies and involve defects in a developing fetus. Fetal hydantoin syndrome is a rare disorder that is believed to be caused by exposure of a fetus to the anticonvulsant drug phenytoin. A case of prenatal diagnosis of fetal hydantoin syndrome by ultrasound.
Fetal hydantoin syndrome nord national organization for rare. Feb 28, 2012 the discussion aims to bring to attention thepotential hazard of the use of hydantoin drug during reproductive age to all medical practitioners. Fetal hydantoin syndrome, phenytoin, congenital anomalies, epilepsycase reporta term baby 41wks was born to a g p l mother with polyhydraminos with seizure disorder. Here are links to possibly useful sources of information about fetal hydantoin syndrome. August 1975 thejournalofpediatrics 285 the fetal hydantoin syndrome five unrelated children born to epileptic women treated with hydantoin anticonvulsants were found to have a similar broad multisystem pattern of abnormalities, including craniofacial anomalies, nail and digital hypoplasia, prenatalonset growth deficiency, and mental deficiency. Fetal hydantoin syndrome genetic and rare diseases information.
The antiepileptic drugs are prescribed to mother due to controlling the seizure attack. Orthopedics the association of congenital anomalies with maternal use of anticonvulsant medicine is welldocumented and has been referred to as fetal hydantoin syndrome. The classic features of fetal hydantoin syndrome include craniofacial anomalies, prenatal and postnatal growth deficiencies, underdeveloped nails of the fingers and toes, and mental retardation. In 89% of these cases, drug treatment started before pregnancy and. This is the first patient report of maternal ingestion of anticonvulsants associated with the triad of fetal hydantoin syndrome, neuroblastoma, and hemorrhagic disease. Fetal hydantoin syndrome an overview sciencedirect topics. Effects due to maternal exposure to hydantoin anticonvulsant. Fetal hydantoin syndrome synonyms, fetal hydantoin syndrome pronunciation, fetal hydantoin syndrome translation, english dictionary definition of fetal hydantoin syndrome. Neurological teratogenic effects of antiepileptic drugs during. Fetal hydantoin syndrome is a characteristic pattern of mental and physical birth. Congenital structural anomalies in offspring of women with epilepsy. The exact incidence and prevalence of the disorder is unknown. May 26, 2015 symptoms, risk factors and treatments of fetal hydantoin syndrome medical condition fetal hydantoin syndrome, also called fetal dilantin syndrome is a group of defects caused to the developing. The risks associated with the intake of dilantin or phenytoin are.
Fetal hypoxia and hyperglycemia in the formation of phenytoin. Symptoms often include physical abnormalities, developmental delays, and slowed growth patterns. After phenytoin treatment, the rat was placed either in an open top plastic cage. Information from the registers was merged through compu terized record. Congenital disorder project gutenberg selfpublishing. Use of the information, documents and data from the echa website is subject to the terms and conditions of this legal notice, and subject to other binding limitations provided for under applicable law, the information, documents and data made available on the echa website may be reproduced, distributed andor used, totally or in part, for noncommercial purposes provided that echa is.