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 Teratology is the study of abnormal development in embryos and the causes of congenital
malformations or birth defects. These anatomical or structural abnormalities are present at
birth although they may not be diagnosed until later in life. They may be visible on the
surface of the body or internal to the viscera
Teratogens are defined as any environmental factor that can produce a permanent
abnormality in structure or function, restriction of growth, or death of the embryo or fetus.
 They are:
chemicals, drugs, or radiation or linked to maternal metabolic disturbances or infections.
 General principles of teratology include the following:
 ▪Teratogens produce growth retardation or malformation. The outcome depends on complex
interactions between the mother, placenta, and fetus.
 ▪Genes of the mother and fetus determine susceptibility to a teratogen (e.g., there is variable
susceptibility to the effects of alcohol).
 ▪Most teratogens are harmful only during a critical window of development (e.g., thalidomide is
teratogenic only between days 28 and 50 of pregnancy).
 ▪Teratogenic agents inhibit specific receptors or enzymes or disrupt specific developmental
pathways (e.g., some agents show neurotropism or cardiotropism).
 ▪Effects of teratogens are dose-dependent. A “safe” dosage may exist; however, in the absence of
certain knowledge, teratogens should be avoided by pregnant women.
 Different organ systems have different periods of susceptibility to exogenous agents.
Teratogenic exposures during prenatal development cause disruptions regardless of the
develop-mental stage or site of action. Most structural defects caused by teratogenic
exposures occur during the embryonic period, which is when critical developmental
events are taking place and the foundations of organ systems are being established.
There are a variety of causes of congenital malformations including:
 1) genetic factors (chromosomal abnormalities as well as single gene defects).
 2) environmental factors (drugs, toxins, infectious etiologies, mechanical forces).
 3) multifactorial etiologies including a combination of environmental and genetic
factors.
 Radiation
 Ionizing radiation (x-rays, mammography,CT scans) can injure the developing embryo due
to cell death or chromosome injury. There is no proof that human congenital
malformations have been caused by diagnostic levels of radiation. The most critical
exposure period is 8-15 wk after fertilization.
Before implantation, the mammalian embryo is insensitive to the teratogenic and
growth-retarding effects of radiation and sensitive to the lethal effects. Permanent growth
retardation is more severe after midgestation radiation.
 Because of its extended periods of organogenesis and histogenesis, the central nervous
system (CNS) retains the greatest sensitivity of all organ systems to the detrimental effects
of radiation through the later fetal stages. In utero radiation produces microcephaly and
mental retardation. Later in life there is increased incidence of hematopoietic
malignancies and leukemia.
 Infectious Agents
e.g Toxoplasmosis , Varicella
 Infections that do not result in congenital malformations but do cause fetal or neonatal
death include enteroviruses (coxsackie virus, poliovirus ,and echovirus) and hepatitis,
variola, vaccina, and mumps viruses.
Varicella: Varicella (or chickenpox) is a highly infectious disease, usually occurring in
childhood.
 The disease is caused by the varicella-zoster virus (VZV), which is a form of the herpes virus.
Transmission occurs from person-to-person by direct contact or through the air.
Chickenpox is contagious from 1 to 2 days before the appearance of the rash until the blisters
have dried and become scabs. Once a person is exposed to the virus, chickenpox may take up
to 14 to 18 days to develop. When a woman has a varicella infection during the first 20 wk of
pregnancy, there is a 2% chance that the baby will have a group of defects called the congenital
varicella syndrome, which includes scars, defects of muscle and bone, malformed and paralyzed
limbs, small head size, blindness, seizures, and mental retardation. This syndrome is rarely
seen if the infection occurs after 20 wk of pregnancy
Varicella zoster virus infection
 Toxoplasmosis Primary maternal infection with Toxoplasma gondii occurs in 1 per
1000 pregnancies. Infection is disseminated through the placenta to the offspring in
40%, with maternal infection by dealing with cat feces .
hydrocephalus and microcephaly result from chronic destructive meningoencephalitis.
 Chorioretinitis may progress to scarring and loss of vision. Hydrocephalus and
cerebral calcifications, hepatitis, and lymphadenopathy are the most common
complications in infants infected prenatally. Organisms have been recovered from the
brain of a congenitally infected infant after 5 yr.