Embryopathy
| Classification according to ICD-10 | |
|---|---|
| Q86.- | Congenital malformation syndromes due to known external causes, not elsewhere classified |
| P35.- | Congenital viral diseases |
| P70.1 | Syndrome of the child of a diabetic mother |
| E70.1 | Other hyperphenylalaninemia |
| ICD-10 online (WHO version 2019) | |
Embryopathy (from the Greek ἔμβρυον, émbryon - the unborn womb , germinating inside and πάθος, páthos - suffering (passion), the addiction, the pathos, the disease ) is a collective term for congenital diseases or malformations caused by various disorders in development the early abdominal fruit up to the 8th week after fertilization (10th week of pregnancy ) ( embryonic development ). Since the organs arise during this sensitive phase of development, damaging influences lead to a miscarriage or various malformations, depending on the cause and degree of severity . Damage after this time is called fetopathy .
causes
Possible causes of embryopathies can be divided into four broad groups:
- Infectious diseases during early pregnancy are among the most well-known causes of embryopathies . These include rubella , rubella , chickenpox , listeriosis , toxoplasmosis and cytomegaly . Embryopathies caused by herpes simplex and Epstein-Barr virus infections have also been described, but very rarely.
- Another large group of triggers for embryopathies are drugs (see Contergan scandal , warfarin embryopathy ), trimethadione embryopathy , chemicals (lead children ) and stimulants ( fetal alcohol syndrome ).
- Also, maternal factors such as age, weight, diet, own diseases such as diabetes , thyroid disorders, phenylketonuria , or heart defects increase the risk of embryopathy.
- Finally, ionizing radiation (X-rays, cosmic radiation, radiation from radioactive substances) - in addition to the genetic risk of damaging the genetic information in the gonads - can damage the developing organism and lead to malformations.
Of course, there are always children with congenital malformations in which the causal damage in early pregnancy cannot be identified.
Symptoms
In the congenital rubella syndrome in particular the heart with heart defects, the eyes with congenital cataracts, so a clouding of the eye lens and a too small eyeball and the auditory pathway in the brain are affected with deafness. The children are often underweight, delayed in their cognitive development and have a comparatively small head circumference ( microcephaly ).
A diabetic embryopathy can also be associated with frequent heart defects, but also congenital malformations of the kidneys and the urinary tract and the skeleton. A strict metabolic control during a planned pregnancy reduces the risk of malformations to the level of metabolically healthy women.
The fetal alcohol syndrome (synonym Fetal Alcohol Syndrome ) manifests itself in addition to the discrete changes of the outer appearance (narrow vermilion, missing or flattened philtrum / dimple in the upper lip, outwardly sloping palpebral fissures, microcephaly u. A.) Most severe in a delay in cognitive development. In 40% of cases, a heart defect can also occur here.
In the case of thalidomide embryopathy caused by the sedative thalidomide, it has been particularly well investigated at which point in time when the drug is acted upon which damage is caused: between the 34th and 38th day after the last menstrual period, the auricle is missing and the auricle becomes paralyzed Facial nerve ( facial nerve palsy ), between the 40th and 44th day arm malformations, between the 43rd and 46th day leg malformations and between the 48th and 50th day thumb malformations and narrowing of the rectum occur.
Social medical aspect
An embryopathic indication is the evidence required for an abortion due to damage to the unborn child , which contains information about the child's disability, malformation or disease that can be asserted as the reason for the abortion. An embryopathic indication is made by the attending physician.
literature
- Roche Lexicon Medicine , ISBN 3-437-15150-9
