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Warfarin embryopathy.
Kiat Yeong Chan1, Enid Gilbert-Barness, George Tiller
1University of South Florida School of Medicine, Tampa, Florida, USA.
Pediatric Pathology & Molecular Medicine
|December 25, 2003
Summary
Warfarin embryopathy, a condition caused by prenatal warfarin exposure, can lead to severe congenital abnormalities. This case highlights the risks of anticoagulation therapy during pregnancy, resulting in multiple fetal malformations.
Area of Science:
- Teratology
- Obstetrics
- Pediatric Cardiology
Background:
- Prophylactic anticoagulation therapy is sometimes necessary during pregnancy, but carries potential risks.
- Warfarin, a common anticoagulant, is known to cross the placenta and can cause fetal harm.
- Maternal pulmonary emboli necessitated anticoagulation in this case.
Observation:
- A pregnancy complicated by maternal pulmonary emboli was managed with anticoagulation.
- Ultrasound revealed fetal hydrocephalus and cardiac defects at 25 weeks' gestation.
- The pregnancy was terminated due to these findings.
Findings:
- The fetus exhibited multiple congenital abnormalities including nasal hypoplasia, earfold atresia, bilobed lungs, coarctation of the aorta, ventricular septal defect, gastroschisis, and skeletal stippling.
- These physical and radiological findings are characteristic of warfarin embryopathy.
- The constellation of anomalies strongly suggests prenatal exposure to warfarin.
Implications:
- This case underscores the teratogenic potential of warfarin during pregnancy.
- Careful risk-benefit assessment is crucial when considering anticoagulation in pregnant patients.
- Awareness of warfarin embryopathy is vital for obstetricians, radiologists, and neonatologists.