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Methotrexate/misoprostol embryopathy: Report of four cases resulting from failed medical abortion
Author(s) -
Adam Margaret P.,
Manning Melanie A.,
Beck Anita E.,
Kwan Andrea,
Enns Gregory M.,
Clericuzio Carol,
Hoyme H. Eugene
Publication year - 2003
Publication title -
american journal of medical genetics part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.064
H-Index - 112
eISSN - 1552-4833
pISSN - 1552-4825
DOI - 10.1002/ajmg.a.20503
Subject(s) - misoprostol , methotrexate , medicine , medical abortion , abortion , ectopic pregnancy , abortifacient , pregnancy , obstetrics , teratology , aminopterin , prostaglandin antagonist , products of conception , gestation , gynecology , prostaglandin , genetics , biology
Abstract Methotrexate, a methyl derivative of aminopterin, is a folic acid antagonist and a known human teratogen; misoprostol is a synthetic prostaglandin E1 analog that causes uterine contractions. Recently, there has been resurgence in the use of methotrexate in combination with misoprostol or of methotrexate alone for the treatment of unwanted or ectopic pregnancies, respectively. This report documents the findings in four infants who were exposed prenatally to methotrexate alone or in combination with misoprostol in a failed attempt at medical abortion or treatment of ectopic pregnancy. All patients demonstrated growth deficiency, with growth parameters <10th centile, and all displayed features consistent with methotrexate and/or misoprostol embryopathy. Since an increasing number of medical abortions are being performed, it is important for physicians to recognize the associated teratogenic effects of these abortifacients. Data from the patients herein described should prompt obstetricians and other health care practitioners who prescribe these medications to counsel their patients regarding these risks, especially if the treatment regimen fails to induce an abortion. © 2003 Wiley‐Liss, Inc.