Fetal hydantoin syndrome, also called fetal dilantin syndrome, is a group of defects caused to the developing fetus by exposure to  teratogenic effects of phenytoin. Dilantin is the brand name of the drug phenytoin sodium in the United States, commonly used in the treatment of epilepsy. It may also be called congenital hydantoin syndrome, fetal hydantoin syndrome, dilantin embryopathy, or phenytoin embryopathy. Association with EPHX1 has been suggested. Signs and symptoms
About one third of children whose mothers are taking this drug during pregnancy typically have intrauterine growth restriction with a small head and develop minor dysmorphic craniofacial features (microcephaly and intellectual disability) and limb defects including hypoplastic nails and distal phalanges (birth defects). Heart defects including ventricular septal defect, atrial septal defect, patent ductus arteriosus and coarctation of the aorta may occur in these children. A smaller population will have growth problems and developmental delay, or intellectual disability. Heart defects and cleft lip may also be featured. Diagnosis
There is no diagnostic testing that can identify fetal hydantoin syndrome. A diagnosis is made clinically based upon identification of characteristic symptoms in an affected infant in conjunction with a history of phenytoin exposure during gestation. It is important to note that the majority of infants born to women who take phenytoin during pregnancy will not develop fetal hydantoin syndrome. Treatment
The treatment of fetal hydantoin syndrome is directed toward the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists.
Originally, the Sauk had a patrilineal and exogamous clan system, in which descent and inheritance was traced through the father. Clans or Mîthonî distinguished and named on the basis of totem animals, which are: Mahkwithowa (Bear Clan), Amehkwithowa (Beaver Clan), Peshekethiwithowa (Deer Clan), Ketiwithowa / Mekethiwithowa (Eagle Clan), Nemêthithowa (Fish Clan), Wâkoshêhithowa (Fox Clan), Kehchikamîwithowa (Ocean/Sea/Great Lake Clan), Keshêhokimâwithowa (Peace Clan), Ahpenîthowa (Potato Clan), Akônithowa (Snow Clan), Nenemehkiwithowa (Thunder Clan), Manethenôkimâwithowa (Warrior Clan), and Mahwêwithowa (Wolf Clan).Saukenuk or Saukietown (today: Black Hawk State Historic Site) near the mouth of the Rock River (Sinnissippi – "rocky waters") into the Mississippi (Mäsesibowi – "great river"), the most important Sauk settlement in the 18th and 19th centuries with about 4,000 inhabitants, was divided into 12 districts, which were assigned to the respective clans. The tribe was governed by a council of sacred clan chiefs, a war chief, the head of families, and the warriors. Chiefs were recognized in three categories: civil, war, and ceremonial. Only the civil chiefs were hereditary. The other two chiefs were recognized by bands after they demonstrated their ability or spiritual power. This traditional manner of selecting historic clan chiefs and governance was replaced in the 19th century by the United States appointing leaders through their agents at the Sac and Fox Agency, or reservation in Indian Territory (now Oklahoma). In the 20th century, the tribe adopted a constitutional government patterned after the United States form. They elect their chiefs.