[Warfarin embryopathy in maternal coumarin therapy for protein S deficiency]

A case of Warfarin embryopathia is shown. The newborn, whose mother had been treated with Marcoumar (Phenprocoumon 3 mg/day) during the whole pregnancy because of a hereditary protein-S-deficiency showed the typical symptom of nasal hypoplasia. Coumarol derivates pass the placental membrane and are known as teratogenic. Recent retrospective and prospective studies show that the risk of fetal or embryonal teratogenic injury is about 25-30% if Coumarol derivates are given through the 6th to the 9th week of pregnancy. It is possible to nearly avoid those injuries when Heparin is used for anticoagulant therapy in this period and Coumarol itself is used in the lowest possible therapeutic dose.