New anomalies due to methotrexate and misoprostol exposure in early pregnancy

MacDonald, Kate; Norman, Wendy V.; Popescu, Oana

doi:10.1016/j.ijgo.2013.03.026

Cited by 11 publications

(13 citation statements)

References 4 publications

(8 reference statements)

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“…111,112 Even low-dose exposure (<20 mg per week) may cause congenital defects. 113 However, the risk when using low-dose treatment seems to be lower than MTX in cancer treatment. Therefore, in cases of inadvertent exposure during early pregnancy, termination of pregnancy is not justified, but treatment should be stopped immediately and a level II ultrasound should be offered in order to examine fetal development.…”

Section: Lactating Contraindicatedmentioning

confidence: 99%

“…Since MTX blocks the synthesis of new DNA, the drug is associated with severe birth defects, including craniofacial abnormalities, limb defects, cardio and genital defects and mental retardation when taken during pregnancy . Even low‐dose exposure (<20 mg per week) may cause congenital defects . However, the risk when using low‐dose treatment seems to be lower than MTX in cancer treatment.…”

mentioning

confidence: 99%

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European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Vestergaard

Wollenberg

Barbarot

et al. 2019

Acad Dermatol Venereol

173

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Atopic dermatitis (AD) is a common inflammatory skin disease that affects both children and adults, including a large number of adults of reproductive age. Several guidelines for the treatment of AD exist, yet specific recommendations for the treatment of pregnant or lactating women and for adults planning to have a child are often lacking. This position paper from the European Task force on Atopic Dermatitis (ETFAD) is based on up‐to‐date scientific literature on treating pregnant and lactating women as wells as adults with AD planning to have a child. It is based on the expert opinions of members of the ETFAD and on existing safety data on the proposed treatments, many of which are derived from patients with other inflammatory diseases or from transplantation medicine. For treating future parents, as well as pregnant and lactating women with AD, the use of topical treatments including moisturizers, topical corticosteroids, tacrolimus, antiseptics such as chlorhexidine, octenidine, potassium permanganate and sodium hypochlorite (bleach) is deemed to be safe. Ultraviolet (UV) therapy may also be used. Systemic treatment should be prescribed only after careful consideration. According to the opinion of the ETFAD, treatment should be restricted to systemic corticosteroids and cyclosporine A, and, in selected cases, azathioprine.

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Section: Lactating Contraindicatedmentioning

confidence: 99%

mentioning

confidence: 99%

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Vestergaard

Wollenberg

Barbarot

et al. 2019

Acad Dermatol Venereol

173

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“…Exposure to misoprostol during the first trimester was 49% and 3%, respectively (odds ratio [OR], 29.7; 95% confidence interval [CI], 11.6 -76). Methotrexate exposure also is characterized by a variety of malformations, including growth restriction, limb defects, and craniofacial anomalies, among others (99). Methotrexate exposure also is characterized by a variety of malformations, including growth restriction, limb defects, and craniofacial anomalies, among others (99).…”

Section: What Methods Can Be Used To Confirm Complete Medical Abortion?mentioning

confidence: 99%

Practice Bulletin No. 143

2014

Obstetrics &Amp; Gynecology

107

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Over the past three decades, medical methods of abortion have been developed throughout the world and are now a standard method of providing abortion care in the United States. Medical abortion, which involves the use of medications rather than a surgical procedure to induce an abortion, is an option for women who wish to terminate a first-trimester pregnancy. Although the method is most commonly used up to 63 days of gestation (calculated from the first day of the last menstrual period), the treatment also is effective after 63 days of gestation. The Centers for Disease Control and Prevention estimates that 64% of abortions are performed before 63 days of gestation (1). Medical abortions currently comprise 16.5% of all abortions in the United States and 25.2% of all abortions at or before 9 weeks of gestation (1). Mifepristone, combined with misoprostol, is the most commonly used medical abortion regimen in the United States and Western Europe; however, in parts of the world, mifepristone remains unavailable. This document presents evidence of the effectiveness, benefits, and risks of first-trimester medical abortion and provides a framework for counseling women who are considering medical abortion.

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“…Nevertheless, manifestations of MTX embryopathy include craniofacial, cardiac, pulmonary, gastrointestinal (GI), genitourinary, and musculoskeletal anomalies. 1,9 We present a case series of patients with limb and other abnormalities associated with in utero MTX exposure.…”

Section: Introductionmentioning

confidence: 99%

Extremity Findings of Methotrexate Embryopathy

Mantilla-Rivas

Brennan²,

Goldrich

et al. 2019

Hand (New York, N,Y.)

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Background: Methotrexate (MTX) is widely used as an immunosuppressant, chemotherapeutic, and abortifacient agent. It is also a potent teratogen, and intentional or unintentional exposure during pregnancy is associated with heterogeneous birth anomalies. Methods: We retrospectively reviewed a cohort of patients who presented to our clinic with limb anomalies in the setting of MTX embryopathy. Results: In our case series, we describe 7 cases of patients who had limb anomalies with heterogeneous functionality, from severely debilitating to completely asymptomatic. Most of the upper extremity anomalies in our group were managed conservatively. Conclusions: Methotrexate embryopathy is a rare but clinically important entity with phenotypic and functional variability. This series underscores the need for proper counseling of patients and raises concern regarding using this medication for the purpose of abortion.

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New anomalies due to methotrexate and misoprostol exposure in early pregnancy

Cited by 11 publications

References 4 publications

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Practice Bulletin No. 143

Extremity Findings of Methotrexate Embryopathy

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