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==Historical Perspective==
==Historical Perspective==
Fetal hydanoin syndrom was first discovered by Meadow et al. in 1968. Manson and Frederic clarified the teratogenic effects of hydantoin in their epidemiological studies in 1973.<ref name="pmid9677735">{{cite journal| author=Ozkinay F, Yenigün A, Kantar M, Ozkinay C, Avanoğlu A, Ulman I| title=Two siblings with fetal hydantoin syndrome. | journal=Turk J Pediatr | year= 1998 | volume= 40 | issue= 2 | pages= 273-8 | pmid=9677735 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9677735  }} </ref>
Fetal hydanoin syndrom was first [[discovered]] by Meadow et al. in 1968. Manson and Frederic clarified the [[teratogenic]] effects of [[hydantoin]] in their [[epidemiological]] studies in 1973.<ref name="pmid9677735">{{cite journal| author=Ozkinay F, Yenigün A, Kantar M, Ozkinay C, Avanoğlu A, Ulman I| title=Two siblings with fetal hydantoin syndrome. | journal=Turk J Pediatr | year= 1998 | volume= 40 | issue= 2 | pages= 273-8 | pmid=9677735 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9677735  }} </ref>
 
==Classification==
There is no established system for the [[classification]] of Fetal hydantoin syndrome.
==Pathophysiology==
 




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There are no established criteria for the diagnosis of fetal hydantoin syndrome.
There are no established criteria for the diagnosis of fetal hydantoin syndrome.
===History and Symptoms===
===History and Symptoms===
The patient with fetal hydantoin syndrome have positive history of exposure to phenytoin during pregnancy.Common symptoms of fetal hydantoin syndrome includes microcephaly, mental retardation, limb defects including hypoplastic nails and distal phalanges, heart defects.
The patient with fetal hydantoin syndrome has a positive history of exposure to phenytoin during pregnancy. Common symptoms of fetal hydantoin syndrome include microcephaly, mental retardation, limb defects including hypoplastic nails and distal phalanges, heart defects.


===Physical Examination===
===Physical Examination===
Common physical examination findings of fetal hydantoin syndrome includes
Common physical examination findings of fetal hydantoin syndrome include
*microcephaly, distinctive facial and limb anomalies, ocular defects, growth deficiency, congenital heart defects, cardiac rhythm disturbances, and variable systemic abnormalities involving the nervous, renal, and gastrointestinal systems.
*microcephaly, distinctive facial and limb anomalies, ocular defects, growth deficiency, congenital heart defects, cardiac rhythm disturbances, and variable systemic abnormalities involving the nervous, renal, and gastrointestinal systems.
*Congenital heart diseases associated with fetal hydantoin syndrome include pulmonary or aortic valvular stenosis, coarctation of aorta, patent ductus arteriosus, and ventricular septal defects.<ref name="pmid28578158">{{cite journal| author=Hegde A, Kaur A, Sood A, Dhanorkar M, Varma HT, Singh G | display-authors=etal| title=Fetal Hydantoin Syndrome. | journal=J Pediatr | year= 2017 | volume= 188 | issue=  | pages= 304 | pmid=28578158 | doi=10.1016/j.jpeds.2017.05.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28578158  }} </ref>
*Congenital heart diseases associated with fetal hydantoin syndrome include pulmonary or aortic valvular stenosis, coarctation of aorta, patent ductus arteriosus, and ventricular septal defects.<ref name="pmid28578158">{{cite journal| author=Hegde A, Kaur A, Sood A, Dhanorkar M, Varma HT, Singh G | display-authors=etal| title=Fetal Hydantoin Syndrome. | journal=J Pediatr | year= 2017 | volume= 188 | issue=  | pages= 304 | pmid=28578158 | doi=10.1016/j.jpeds.2017.05.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28578158  }} </ref>


===Laboratory Findings===
===Laboratory Findings===

Revision as of 13:21, 9 May 2021

Overview

Fetal hydantoin syndrome (FHS), characterized by altered growth and development, has been well described in recent years in the fetus of epileptic mothers taking phenytoin or other hydantoin anticonvulsants during the gestational period.[1]


Historical Perspective

Fetal hydanoin syndrom was first discovered by Meadow et al. in 1968. Manson and Frederic clarified the teratogenic effects of hydantoin in their epidemiological studies in 1973.[2]

Classification

There is no established system for the classification of Fetal hydantoin syndrome.

Pathophysiology

Epidemiology and Demographics

The risk of neurological impairment estimated to be 1% to 11% is 2 to 3 times higher than in the general population. The risk of oral clefts and cardiac anomalies is 5 times than others in hydantoin exposed infants. Less frequently observed abnormalities include microcephaly, ocular defects, hypospadias, umbilical and inguinal hernias.[3]

Diagnosis

Diagnostic Study of Choice

There are no established criteria for the diagnosis of fetal hydantoin syndrome.

History and Symptoms

The patient with fetal hydantoin syndrome has a positive history of exposure to phenytoin during pregnancy. Common symptoms of fetal hydantoin syndrome include microcephaly, mental retardation, limb defects including hypoplastic nails and distal phalanges, heart defects.

Physical Examination

Common physical examination findings of fetal hydantoin syndrome include

  • microcephaly, distinctive facial and limb anomalies, ocular defects, growth deficiency, congenital heart defects, cardiac rhythm disturbances, and variable systemic abnormalities involving the nervous, renal, and gastrointestinal systems.
  • Congenital heart diseases associated with fetal hydantoin syndrome include pulmonary or aortic valvular stenosis, coarctation of aorta, patent ductus arteriosus, and ventricular septal defects.[4]

Laboratory Findings

  1. Jimenez JF, Seibert RW, Char F, Brown RE, Seibert JJ (1981). "Melanotic neuroectodermal tumor of infancy and fetal hydantoin syndrome". Am J Pediatr Hematol Oncol. 3 (1): 9–15. PMID 6263127.
  2. Ozkinay F, Yenigün A, Kantar M, Ozkinay C, Avanoğlu A, Ulman I (1998). "Two siblings with fetal hydantoin syndrome". Turk J Pediatr. 40 (2): 273–8. PMID 9677735.
  3. Singh R, Kumar N, Arora S, Bhandari R, Jain A (2012). "Fetal hydantoin syndrome and its anaesthetic implications: a case report". Case Rep Anesthesiol. 2012: 370412. doi:10.1155/2012/370412. PMC 3469078. PMID 23082254.
  4. Hegde A, Kaur A, Sood A, Dhanorkar M, Varma HT, Singh G; et al. (2017). "Fetal Hydantoin Syndrome". J Pediatr. 188: 304. doi:10.1016/j.jpeds.2017.05.018. PMID 28578158.