- Umbilical vein varix
- Timing of Cranial Markers in Open NTD
- Real world experience Open Neural tube defect and Brain Signs
- Real world experience First Trimester Megacystis – Management
- Real world experience Fetal Megacystis
- Abnormal facial profile
- Azygous Vein & ARSA
- Blakes Pouch Cyst
- Absent nasal bone (ANB)
- Choroid plexus cysts
- Chronic placental abruption
- Fetal Alcohol Syndrome
- Placenta-First Risk Stratification
Fetal Alcohol Syndrome
FAS requires:
1. Characteristic facial features
2. Growth restriction
3. Neurodevelopmental impairment
Alcohol dose
The uncomfortable truth
There is no proven safe dose in pregnancy.
Why?
• Placenta does not block alcohol
• Fetal blood alcohol ≈ maternal level
• Fetal liver cannot metabolize alcohol
• Individual susceptibility varies
Dose categories
| Exposure pattern | Fetal risk |
|---|---|
| Heavy chronic drinking (daily, ≥2–3 drinks/day) | Very high risk of FAS |
| Binge drinking (≥4–5 drinks in one sitting) | High risk, even if infrequent |
| Low-level regular drinking (1 drink/day) | Increased neurodevelopmental risk |
| Occasional small amounts | Risk cannot be excluded |
Why dose–response is unpredictable
• Genetic susceptibility
• Maternal metabolism
• Nutrition (folate, choline)
• Timing of exposure
• Placental transport differences
➡ Two women drinking the same amount can have very different fetal outcomes.
Gestational age: timing matters more than total dose
First trimester (3–8 weeks): organogenesis
Highest risk for classic FAS
Alcohol exposure here causes:
• Facial anomalies
• Cardiac defects
• Limb anomalies
• Brain malformations