Abstract
Introduction
Fetal warfarin syndrome (warfarin embryopathy) is a consequence of maternal ingestion of warfarin during pregnancy. Warfarin fetotoxicity comprises wide range of manifestations including dysmorphology in neonate with characteristic classical features of nasal hypoplasia and stippling of epiphyses.
Materials and methods
Here we present a case of a neonate whose mother was on unsupervised warfarin prophylaxis throughout pregnancy. A brief review of literature with suitable options for anticoagulation during pregnancy is discussed.
Conclusion
The final consensus over LMWH and warfarin in the first trimester is yet to be finalised. The treatment of warfarin embryopathy is symptomatic. Long term sequels in survivors are still not known.
References
Wong V, Cheng CH, Chan KC (1993) Fetal and neonatal outcome of exposure to anticoagulants during pregnancy. Am J Med Genet 45(1):17–21
Hou JW (2004) Fetal warfarin syndrome. Chang Gung Med J 27(9):691–695
Bony C, Zyka F, Tiran-Rajaofera I, Attali T, De Napoli S, Alessandri JL (2002) Warfarin fetopathy. Arch Pediatr 9(7):705–708
Hall JG, Pauli RM, Wilson KM (1980) Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 68:122–140
Chan KY, Gilbert-Barness E, Tiller G (2003) Warfarin embryopathy. Pediatr Pathol Mol Med 22:277–283
Menon RK, Gill DS, Thomas M, Kernoff PB, Dandona P (1987) Impaired carboxylation of osteocalcin in warfarin-treated patients. J Clin Endocrinol Metab 64:59–61
Tongsong T, Wanapirak C, Piyamongkol W (1999) Prenatal ultrasonographic finding consistent with fetal warfarin syndrome. J Ultrasound Med 18:577–580
Wesseling J, Van Driel D, Smrkovsky M, Van der Veer E, Geven-Boere LM, Sauer PJJ, Touwen BCL (2001) Neurological outcome in school-age children after in utero exposure to coumarins early human development, vol 63, Issue 2, July 2001, pp 83–95
Royal College of Obstetricians and Gynaecologists (2001) Thromboembolic disease in pregnancy and the puerperium: acute management. Guideline No. 28, RCOG Press, London
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Mehndiratta, S., Suneja, A., Gupta, B. et al. Fetotoxicity of warfarin anticoagulation. Arch Gynecol Obstet 282, 335–337 (2010). https://doi.org/10.1007/s00404-010-1369-5
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DOI: https://doi.org/10.1007/s00404-010-1369-5