A pediatric patient should be evaluated for the fetal alcohol syndrome (FAS) if certain clinical findings (triggers) are identified.


Indications for a diagnostic evaluation of a fetus for FAS:

(1) definite significant exposure to alcohol during the pregnancy

(2) concern of a parent or caregiver about the diagnosis

(3) presence of all 3 facial features (smooth philtrum, thin vermillion border, small palpebral fissures)

(4) presence of one or more facial features AND one or both of the following:

(4a) growth retardation (height, weight or both)

(4b) one or more CNS abnormalities


When the possibility of FAS should be considered:

(1) premature maternal death related to alcohol misuse

(2) one or both parents are alcoholic

(3) history of or evidence for abuse or neglect

(4) history of investigation by child protective services

(5) transient or permanent caregiving by someone other than the parents


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