PLANNING FOR YOUR  PREGNANCY (continued) 2. Alcohol Alcohol use during pregnancy is a significant problem: it has been estimated that as many as 1 in 300 infants are born with some stigmata of fetal alcohol exposure. The most well described stigmata are part of the Fetal Alcohol Syndrome (FAS) which includes 1) prenatal and postnatal growth retardation, 2) central nervous system involvement, and 3) characteristic facial features. The central nervous system effects include tremulousness, poor suckling, abnormal muscle tone, hyperactivity, attention deficit, and mental retardation. The typical facial features include microcephaly (a small head), a thin upper lip, a short upturned nose, a flattened nasal bridge (upper portion of the nose), and general underdevelopment of the mid face area. Drinking patterns vary among women, and it appears that heavier drinking is associated with more congenital problems. However, it is important to know that no safe level of alcohol intake during pregnancy has ever been defined. Both binge drinking and daily drinking increase the risk both of fetal abnormalities, such as in the FAS, and of fetal death. Alcohol use during pregnancy is associated with an increased incidence of second trimester miscarriage in moderate to heavy drinkers. Abrupt ion of the placenta and breech presentation also appear to be more common in fetuses with the fetal alcohol syndrome. Other fetal defects which may be associated with alcohol exposure include congenital heart defects, brain abnormalities, spinal bifida, limb defects, urinary tract defects, and genital defects.   (The material presented here has been adopted from a pamphlet written and distributed by the American College of Obstetricians and Gynecologists.)