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[Pregnancy after isotretinoin use]
Klaartje C Manders1, Loes C de Vries, Frans J M E Roumen
1Elkerliek Ziekenhuis, afd. Gynaecologie en Obstetrie, Helmond.
Background:
Acne is a common problem that is increasingly being effectively treated with isotretinoin, a highly teratogenic agent. According to the pregnancy prevention program, contraception should be used until at least one month after discontinuing the medication.
Case Description:
A 29-year-old woman became pregnant shortly after discontinuing isotretinoin. She was referred to the gynaecologist for an abortion. However, since she wished to continue the pregnancy, she received personal advice on the risk of bearing a child with congenital abnormalities. After an uneventful pregnancy she gave birth to a healthy son.
Conclusion:
Given the teratogenicity of isotretinoin, every woman in the fertile phase of life should use contraception while taking the medication. If she becomes pregnant, however, the individual risk of having a child with congenital abnormalities can be carefully and reliably estimated by determining the precise date of conception through ultrasound and the date that isotretinoin was stopped.
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