Now I wanna talk about something that's really serious
when it comes to placental drug transfer. We just call it the thalidomide disaster.
Most people, obviously, if you weren't even born during this time,
it's in the back of their minds when you worry about taking a medication when you're pregnant.
Now, no one knows how many miscarriages this drug caused
but it's estimated that in one country, in Germany alone, 10,000 babies were born affected by thalidomide.
Now, the reason this happened is because thalidomide was marketed
as a mild sleeping pill safe even for pregnant women.
Also in the 1950s and the 1960s, thalidomide was used to treat morning sickness during pregnancy.
Well, if you take trouble with sleeping and morning sickness,
those were huge numbers of pregnant women this drug that was thought to be safe was recommended for.
Well, it ended up finding out that it was not safe for pregnant women.
In fact, it caused severe birth defects.
Thousands of babies worldwide were born with malformed limbs.
Now you see an example, a picture of a child here, it's one example of the malformed limbs caused by this drug.
Now, thalidomide is still used today for very specific reasons.
Obviously, not given to pregnant women
but it has another role in place in a correct administration that can be beneficial to patients
but this was a disaster.
A medication that we thought to be safe, particularly for pregnant women, was not.
So let's give it the official name, teratogen.
Now, thalidomide is an extreme example of teratogen.
It's an agent that can disturb the development of the embryo or fetus.
Now, clearly you saw a visual picture of what that ended up looking like for thousands of children
who are born after thalidomide.
So just underline that word, teratogen, so it sticks out in your mind.
Remember, thalidomide is an extreme example of that
but it's one that will always stick with you.
So know that that's what we're worried about with pregnant moms taking medications.
We're worried about placental drug transfer and we just call that name teratogen.
Those are the ones we don't want a mom to take
because it disturbs the development of the embryo and the fetus.
Now, teratogenesis is the process by which it happens.
So teratogen is the source that caused it.
Teratogenesis is the creation of terato, right?
So that's the process by which these congenital malformations are produced in an embryo or a fetus.
So just a couple of vocabulary words for you to be familiar with that you'll see in literature.
Now we talked about birth defects.
You'll see the term gross malformations.
That's a pretty emotionally-charged word but this is what they mean.
Now before I break down what gross malformations are, I just wanna remind you
less than 1% of all birth defects are caused by drugs.
So if your baby is in that less 1%, I understand it's a huge deal
but I want you to keep in mind that it's only less than 1% of all birth defects
are actually caused by drugs.
There's lots of reasons and causes for birth defects
so it makes it very difficult to identify the cause or the teratogen.
It's pretty tough to narrow down sometimes.
Now hopefully we would do it quicker than they did with thalidomide in the 50s and 60s
but still, it takes a while sometimes to make that connection.
So there's only a few drugs that are actually considered proven teratogens and that's why.
Okay, so let's look at some of the gross malformations.
Cleft palate, clubfoot which you see pictured there, and hydrocephalus.
Now when we are researching for this presentation,
if you'll Google hydrocephalic babies, I was taken aback.
I could not take my eyes away from those pictures.
They are pitiful pictures of children with enormously enlarged heads.
So lots of kids have hydrocephalus and it's not as extreme
but there's some very extreme pictures of children with severe, severe hydrocephalus.
I mean, they're just extra fluid in the ventricles of their brain
but particularly with babies, their heads can become extremely swollen.
Some of them almost look like alien babies to me so if you wanna have a visual picture
of what a severely extreme case would look like,
there are plenty available on Google for you to take a look.
So you have the two categories of birth defects: gross malformations
or neurobehavioral or metabolic abnormalities.
Those are a little trickier to diagnose.
The cleft palate, you're gonna see immediately.
Clubfoot, you're gonna notice that right away.
And hydrocephalic becomes evident pretty quickly.
So teratogenesis, genesis means the making of new, right?
This means the creation or the process of these birth defects.