Explanation:
Fetal alcohol syndrome is characterized by maternal alcohol use, growth restriction, facial anomalies, and central nervous system dysfunction. The typical facial features include small palpebral fissures (eye openings) andepicanthal folds, flat nasal bridge, smooth philtrum, thin upper lip, and low set ears. Fetal alcohol syndrome is the most common cause of nongenetic developmental delay. Screening for alcohol use in pregnancy should be performed at every initial prenatal visit.
The TACE questions (i.e., tolerance, annoyed, cut down, eye opener), similar to the CAGE (cut down, annoyed, guilty, eye opener) mnemonic, are validated for screening in pregnancy. If a woman screens positive, a brief intervention should occur, and referral to a substance abuse expert should be made.
Isotretinoin (B) is a highly teratogenic medication used in the treatment of cystic acne, which can cause, in a fetus, microtia or anotia, micrognathia, cleft palate, transposition of great vessels and ventricular septal defects, hydrocephalus, thymic defects, retinal or optic nerve defects, and mental retardation. Lisinopril (C), as well as other angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, causes fetal renal dysfunction, leading to oligohydramnios, limb contractions, and craniofacial deformities. Methamphetamine (D) is not associated with any teratogenic effects, however, it does increase the risk of placental abruption, preterm birth, intrauterine fetal death, and infant death.
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