acenocoumarol and Chondrodysplasia-Punctata

We report a case of warfarin embryopathy. This disease affects more than 6% of fetuses exposed in utero to a vitamin K antagonist.. A child whose mother was treated with acenocoumarol because of a mechanical heart valve presented with signs of warfarin embryopathy. He showed chondrodysplasia punctata with telebrachydactyly, facial dysmorphism with nasal hypoplasia, a cataract, and a bilateral pyeloureteral junction syndrome.. Characteristics of this drug induced embryopathy are reminded, while bearing in mind the conflict of interests between the mother and the fetus. The mechanisms of this embryopathy are debated in light of the recent knowledge concerning fetal metabolism of vitamin K.

Topics: Abnormalities, Drug-Induced; Acenocoumarol; Adult; Age Factors; Anticoagulants; Child, Preschool; Chondrodysplasia Punctata; Female; Fetus; Follow-Up Studies; Heart Valve Prosthesis; Humans; Infant; Male; Pregnancy; Pregnancy Complications, Cardiovascular; Prenatal Exposure Delayed Effects; Time Factors; Warfarin

Topics: 4-Hydroxycoumarins; Abnormalities, Drug-Induced; Acenocoumarol; Adult; Chondrodysplasia Punctata; Female; Humans; Phenprocoumon; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third

The ability of most anticoagulants (except heparin) to cross the placenta and the consequent hemorrhage in the fetus has been recognized for some time (3). A teratogenic effect specifically attributed to warfarin sodium is a more recent finding (7, 9, 10). The following is a case report of a newborn with clinical and roentgenographic features similar to the cases reported previously.

Topics: Abnormalities, Drug-Induced; Abnormalities, Multiple; Acenocoumarol; Adult; Chondrodysplasia Punctata; Female; Humans; Infant, Newborn; Maternal-Fetal Exchange; Pregnancy