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Fetal warfarin syndrome.

¹Division of Medical Genetics, Department of Pediatrics, Chang Gung Children's Hospital, 5, Fushing Street, Gueishan Shiang, Taoyuan, Taiwan 333, ROC. houjw741@cgmh.org.tw

Chang Gung Medical Journal

|December 21, 2004

Summary

Fetal warfarin syndrome (FWS) is a rare condition caused by maternal warfarin use during pregnancy. This case highlights typical FWS features in an infant exposed to warfarin for maternal heart valve replacement.

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Area of Science:

Teratology
Pharmacology
Pediatrics

Background:

Warfarin (coumadin) is an anticoagulant medication with known teratogenic potential.
Maternal use of warfarin during pregnancy, particularly in the first trimester, can lead to Fetal Warfarin Syndrome (FWS).
This syndrome is associated with specific patterns of congenital anomalies.

Observation:

A male infant presented with characteristic features of FWS.
Maternal history revealed warfarin treatment for a mechanical heart valve due to rheumatic heart disease.
Observed anomalies included nasal bridge hypoplasia, laryngomalacia, pectus carinatum, congenital heart defects, ventriculomegaly, stippled epiphyses, telebrachydactyly, and growth retardation.

Findings:

The infant's presentation is consistent with established clinical descriptions of FWS.
Facial dysmorphism, skeletal abnormalities, and cardiac defects were prominent.
The case underscores the risks of warfarin embryopathy in infants exposed in utero.

Implications:

Early recognition and diagnosis of FWS are crucial for appropriate management.
Understanding the teratogenic effects of warfarin informs clinical decision-making regarding anticoagulation in pregnant patients.
Further research into the pathogenesis and management strategies for FWS is warranted.

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