Pdf letters to the editor are wdcomed for publication subject to editing. Various studies have suggested an approximate incident rate of 510% of fetal hydantoin syndrome in infants exposed to phenytoin in utero. Symptoms often include physical abnormalities, developmental delays, and slowed growth patterns. An infant with features of fetal hydantoin syndrome, born to an epileptic mother, was foilowed from birth to 20 months of age.
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. Fetal hydantoin syndrome is a disorder that is caused by exposure of a fetus to phenytoin, a drug commonly prescribed for epilepsy. Hydantoin definition of hydantoin by the free dictionary. Statistics of fetal hydantoin syndrome 0 people with fetal hydantoin syndrome have taken the sf36 survey. Hanson jw, myrianthopoulos nc, harvey ma, smith dw j pediatr 1976 oct. Fetal valproate syndrome nord national organization for. Letters must be signed by au authors, typewrittes double spaced, and most not exceed two pages of text including references. Fetal hydantoin syndrome characteristics jama pediatrics. The distinctive cutaneous features of the fetal hydantoin syndrome may bring the disorder to the attention of the. The distinctive cutaneous features of the fetal hydantoin syndrome may bring the disorder to the attention of the dermatologist.
Fetal alcohol syndrome definition of fetal alcohol. The range and severity of associated abnormalities will vary greatly from one infant to another. Fetal hydantoin syndrome definition of fetal hydantoin. Of infants born to women who used phenytoin during pregnancy, 1030% are reported to show some of the characteristics associated with this syndrome. Fetal hydantoin syndrome, phenytoin, congenital anomalies, epilepsycase reporta term baby 41wks was born to a g p l mother with polyhydraminos with seizure disorder. Use of phenytoin in pregnancy for epileptic seizure prevention. Fetal hydantoin syndrome final linkedin slideshare. Physical findings included gum hypertrophy, digitaiization of the thumbs, hypopiasia of the distal phalanges and nails, epicanthai folds, pseudohyperteiorism, epidermoid cyst, and geographic tongue. The increased incidence of fetal malformation after gestational exposure to hydantoin has been reported in pediatric, 1 obstetric, 1 and general medical 3 journals but not previously, to my knowledge, in the dermatologic literature. Fetal hydantoin syndrome is caused by the exposure of the fetus to phenytoin or dilantin, an anticonvulsant drug which is prescribed for epilepsy cases. Dilantin, phenytoin and a few other similar anticonvulsants are also included. Fetal hydantoin syndrome an overview sciencedirect topics. Fetal hydantoin syndrome is by far the bestcharacterized malformation complexes induced by anticonvulsant drugs used to treat maternal epilepsy. 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.
But the patient also had an imperforate anus, a rectovaginal fistula, renal agenesis, a dislocated hip, multiple rib and. The antiepileptic drugs are prescribed to mother due to controlling the seizure attack. Some of the principal syndromes of this disorder include microcephaly or developing an unusually small head, brain malfunctions, developmental delays, growth deficiencies. Jul 11, 2019 fetal hydantoin syndrome is a drugrelated embryofetopathy that can occur when an embryofetus is exposed to the anticonvulsant drug. May 26, 2015 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. 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. The exact incidence and prevalence of the disorder are unknown. Risks to the offspring of women treated with hydantoin anticonvulsants, with emphasis on the fetal hydantoin syndrome.
Fetal alcohol spectrum disorders fasds are a group of conditions that can occur in a person whose mother drank alcohol during her pregnancy. Fetal alcohol syndrome fas which is characterized by 1. Fetal hydantoin syndrome is a rare disorder that is believed to be caused by exposure of a fetus to the anticonvulsant drug phenytoin. In the 60s, effects attributed to this medication were grouped into a somewhat recognizable pattern of anomalies briggs et al. Fetal hydantoin syndrome is a characteristic pattern of mental and physical birth defects that results from maternal use of the antiepileptic drug phenytoin dilantin during pregnancy. Fetal hydantoin syndrome symptoms,causes,treatment and more. Hanson jw, myrianthopoulos nc, harvey ma, et al risks to the offspring of women treated with hydantoin anticonvulsants, with emphasis on the fetal hydantoin syndrome. The abnormalities found in children with fetal hydantoin syndrome. Sibs exposed to similar amount have been affected to different degrees. Fetal hydantoin syndrome fhs is a fetopathy likely to occur when a pregnant women takes hydantoin for epileptic seizures. Those affected are more likely to have trouble in school, legal. Problems may include an abnormal appearance, short height, low body weight, small head size, poor coordination, low intelligence, behavior problems, and problems with hearing or seeing. 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. There is a wide range in the nature and severity of characteristics associated with fetal hydantoin syndrome.
Fetal hydantoin syndrome pictures, causes, symptoms, diagnosis. Pubmed is a searchable database of medical literature and lists journal articles that discuss fetal hydantoin syndrome. The new england journal of medicine, 329, 16601661. Fetal hydantoin syndrome symptoms,causes,treatment and.
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. Fetal hydantoin syndrome is a characteristic pattern of mental and physical birth defects that results from maternal use of the antiseizure anticonvulsant drug phenytoin dilantin during pregnancy. Chernoff, variable patterns of malformation in the mouse fetal hydantoin syndrome, american journal of medical genetics, 19, 3, 463471, 2005. Description fas is the most common preventable cause of mental retardation. To test the effect of maternal seizure disorders on prenatal structural development, the mouse neurological mutant quaking qk was used. For more information on this disorder choose fetal hydantoin syndrome as your search term in the rare disease database. Prenatal prediction of risk of the fetal hydantoin syndrome. Fetal hydantoin syndrome medical condition youtube. Total score ranges from 0 to 3,600 being 0 the worst and 3,600 the best. Fetal growth, major malformations, and minor anomalies in infants born to women receiving valproic acid. Meadow was the first to note a possible link between congenital abnormalities and maternal use of anticonvulsive drug in 1968. Fetal hydantoin syndrome nord national organization for. It is important to remember that of all the infants exposed to this drug only a few will be affected by this disorder.
Dilantin is the brand name of the drug phenytoin sodium in the united states, commonly used in. Fetal hydantoin syndrome jama dermatology jama network. Verification of the fetal valproate syndrome phenotype. Fetal hydantoin syndrome affects males and females in equal numbers. Kogutt and young described a newborn with multiple congenital anomalies as having a case of the fetal hydantoin syndrome. 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 dilantin tm during pregnancy. When embryo or the unborn fetus expose to phenytoin, an anticonvulsant agent causes anatomical disorders, which is termed as a fetal hydantoin syndrome.
Phenytoin has a marked seizureinhibiting effect, and is effective with grandmal seizures, focal epilepsy, sensory and psychomotor seizures, and in status epilepticus. This condition was first recognized and reported in the medical literature in. The discussion aims to bring to attention thepotential hazard of the use of hydantoin drug during reproductive age to all medical practitioners. Dilantin is the brand name of the drug phenytoin sodium in the united states, commonly used in the treatment of epilepsy. The code is valid for the year 2020 for the submission of hipaacovered transactions. Pattern of malformations in the children of women treated with carbamazepine during pregnancy. Fetal hydantoin syndrome genetic and rare diseases.
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. Dec 07, 2011 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. Fetal alcohol syndrome definition fetal alcohol syndrome fas is a pattern of birth defects, learning, and behavioral problems affecting individuals whose mothers consumed alcohol during pregnancy. Classical indicators of fhs were classified by hanson 1986 into three distinct sets. Not all infants exposed to phenytoin will be affected with the disorder. Nov 06, 2017 fetal hydantoin syndrome affects males and females in equal numbers. Fetal hydantoin syndrome how is fetal hydantoin syndrome. Fetal hydantoin syndrome dr rohit sharma and radswiki et al. Research has shown that anticonvulsants are teratogens and pose a risk for fetal malformations. Pmc free article ardinger hh, atkin jf, blackston rd, elsas lj, clarren sk, livingstone s, flannery db, pellock jm, harrod mj, lammer ej, et al. Letters must be signed by au authors, typewrittes double spaced, and most. Click on the link to view a sample search on this topic.
Fetal hydantoin syndrome radiology reference article. 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. Fetal hydantoin syndrome is a drugrelated embryofetopathy that can occur when an embryofetus is exposed to the anticonvulsant drug. A clinical study of 57 children with fetal anticonvulsant. Less frequently observed anomalies include cleft lip and palate. Physical findings included gum hypertrophy, digitaiization of the. Fetal hydantoin syndrome pictures, symptoms, causes. Fetal hydantoin syndrome pictures, causes, symptoms. Risks to the offspring of women treated with hydantoin anticonvulsants with emphasis on the fetal hydantoin syndrome. Fetal hydantoin syndrome is a rare medical condition in which a developing fetus is exposed to a seizure medication known as phenytoin.
Apr 15, 2020 fetal hydantoin syndrome is a rare medical condition in which a developing fetus is exposed to a seizure medication known as phenytoin. A case of prenatal diagnosis of fetal hydantoin syndrome. This page includes the following topics and synonyms. An anticonvulsant drug, c15h12n2o2, used to treat epilepsy, often in the form of its sodium salt. Pharmacology phenytoin is the most widely used hydantoin derivative with an antiepileptic effect. Jun 23, 2019 fetal hydantoin syndrome pdf disease definition. Aug 10, 2011 access to this database is free of charge.
Handbook of genetic counselingfetal hydantoin syndrome. Another scientific approach for progression of fetal hydantoin syndrome is due to abnormal genetic difference causes generation of free radicals from intermediate metabolites of phenytoin causes teratogenesis, as it binds to dna, proteins, and lipids and that adversely affects neurodevelopment. This is rare symptom, as most of the time doctors avoid prescribing phenytoin to women in their childbearing age. Fetal hydantoin syndrome is a disorder that is caused by exposure of a fetus.
Fetal hydantoin syndrome synonyms, fetal hydantoin syndrome pronunciation, fetal hydantoin syndrome translation, english dictionary definition of fetal hydantoin syndrome. Fetal hydantoin syndrome and its anaesthetic implications. Administering phenytoin in the drinking water of females homozygous for the quaking allele reduced the frequency of tonic. A clinical diagnosis of fetal hydantoin syndrome secondary to in utero phenytoin exposure was considered. A pattern of fetal anomalies associated with hydantoin, of which phenytoin is a derivative, was first described in the literature in 1975. Drug is thought to deplete already low levels of fetal vitamin k therefore suppressing the vitamin kdependent coagulation factors ii, vii, ix, and x. An additional 30% of children who are exposed during embryonic development show lesser degrees of alteration. The infant had hypoplastic distal phalanges and hypoplastic fingernails, which are common manifestations of the fetal hydantoin syndrome. 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. Effects due to maternal exposure to hydantoin anticonvulsant.
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