BACKGROUND: Methotrexate is an antineoplastic agent used by obstetrician-gynecologists for termination of early pregnancy. The drug is not always successful and is associated with a known array of malformations. CASE: We present a case of a failed pregnancy termination with methotrexate, which resulted in fetal anomalies. Ultrasound revealed absent or markedly shortened long bones, abnormal positioning of the hands, micrognathia, echogenic bowel, and a two-vessel umbilical cord. The patient elected to undergo pregnancy termination, and the ultrasound findings were confirmed at autopsy. CONCLUSION: Because of methotrexate's teratogenic potential, follow-up to confirm successful termination is necessary. Ultrasound evaluation of the fetus is indicated if pregnancy termination is unsuccessful.
BACKGROUND:Methotrexate is an antineoplastic agent used by obstetrician-gynecologists for termination of early pregnancy. The drug is not always successful and is associated with a known array of malformations. CASE: We present a case of a failed pregnancy termination with methotrexate, which resulted in fetal anomalies. Ultrasound revealed absent or markedly shortened long bones, abnormal positioning of the hands, micrognathia, echogenic bowel, and a two-vessel umbilical cord. The patient elected to undergo pregnancy termination, and the ultrasound findings were confirmed at autopsy. CONCLUSION: Because of methotrexate's teratogenic potential, follow-up to confirm successful termination is necessary. Ultrasound evaluation of the fetus is indicated if pregnancy termination is unsuccessful.
Authors: Fokaline Vroom; Hermien E K de Walle; Mart A J F van de Laar; Jacobus R B J Brouwers; Lolkje T W de Jong-van den Berg Journal: Drug Saf Date: 2006 Impact factor: 5.606
Authors: Monika Østensen; Munther Khamashta; Michael Lockshin; Ann Parke; Antonio Brucato; Howard Carp; Andrea Doria; Raj Rai; Pierluigi Meroni; Irene Cetin; Ronald Derksen; Ware Branch; Mario Motta; Caroline Gordon; Guillermo Ruiz-Irastorza; Arsenio Spinillo; Deborah Friedman; Rolando Cimaz; Andrew Czeizel; Jean Charles Piette; Ricard Cervera; Roger A Levy; Maurizio Clementi; Sara De Carolis; Michelle Petri; Yehuda Shoenfeld; David Faden; Guido Valesini; Angela Tincani Journal: Arthritis Res Ther Date: 2006-05-11 Impact factor: 5.156