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[Fetal hydantoin syndrome in siblings]
Schweizerische Medizinische Wochenschrift
|January 20, 1979
Summary
Exposure to hydantoin during pregnancy can cause fetal hydantoin syndrome in children, leading to developmental delays and distinct physical abnormalities. This highlights the need to avoid hydantoin in women of childbearing age unless using contraception.
Area of Science:
- Teratology
- Developmental Pediatrics
- Clinical Neurology
Background:
- Epilepsy treatment during pregnancy poses risks to fetal development.
- Hydantoin (phenytoin) is an anticonvulsant medication used to manage epilepsy.
- Maternal anticonvulsant therapy requires careful consideration of potential teratogenic effects.
Observation:
- Two siblings exposed to hydantoin in utero presented with characteristic fetal hydantoin syndrome.
- Both children exhibited growth retardation, microcephaly, and distinct dysmorphic features.
- Specific anomalies included ridged metopic suture, hypertelorism, nasal hypoplasia, distal phalangeal/nail hypoplasia, and inguinal hernias.
Findings:
- The 18-month-old female showed epicanthal folds, strabismus, ptosis, and a ventricular septal defect.
- The 6.5-year-old male displayed severe intellectual disability, absent speech, and infantile autism.
- Maternal dosage varied (300-400 mg daily), with significant developmental impacts observed in offspring.
Implications:
- Approximately 50% of offspring from epileptic women on hydantoin therapy experience mental retardation.
- 11% of these infants exhibit the full spectrum of fetal hydantoin syndrome dysmorphic features.
- Strict avoidance of hydantoin in women of childbearing age is recommended, alongside contraception or consideration of therapeutic abortion if continued use is necessary.