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Importance of a multidisciplinary approach and monitoring in fetal warfarin syndrome
Author(s) -
Silveira Daniélle B.,
da Rosa Ernani B.,
de Mattos Vinicius F.,
Goetze Thayse B.,
Sleifer Pricila,
Santa Maria Fernanda D.,
Rosa Rosana C. M.,
Rosa Rafael F. M.,
Zen Paulo R. G.
Publication year - 2015
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.36655
Subject(s) - medicine , pectus excavatum , warfarin , mouth breathing , craniofacial , nose , craniofacial abnormality , surgery , breathing , anesthesia , cardiology , psychiatry , atrial fibrillation
Warfarin is a synthetic oral anticoagulant that crosses the placenta and can lead to a number of congenital abnormalities known as fetal warfarin syndrome. Our aim is to report on the follow‐up from birth to age 8 years of a patient with fetal warfarin syndrome. He presented significant respiratory dysfunction, as well as dental and speech and language complications. The patient was the second child of a mother who took warfarin during pregnancy due to a metallic heart valve. The patient had respiratory dysfunction at birth. On physical examination, he had a hypoplastic nose, pectus excavatum, and clubbing of the fingers. Nasal fibrobronchoscopy showed upper airway obstruction due to narrowing of the nasal cavities. He underwent surgical correction with Max Pereira graft, zetaplasty, and osteotomies for the piriform aperture. At dental evaluation, he had caries and delayed eruption of the upper incisors. Speech and language assessment revealed high palate, mouth breathing, little nasal patency, and shortened upper lip. Auditory long latency and cognitive‐related potential to auditory stimuli demonstrated functional changes in the cortical auditory pathways. We believe that the frequency of certain findings observed in our patient may be higher in fetal warfarin syndrome than is appreciated, since a significant number result in abortions, stillbirths, or children evaluated in the first year of life without a follow‐up. Thus, a multidisciplinary approach and long‐term monitoring of these patients may be necessary. © 2015 Wiley Periodicals, Inc.