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Obstet Gynecol. 2005 May;105(5 Pt 2):1203-5.

Anomalies associated with failed methotrexate and misoprostol termination.

Author information

1
Department of Family Practice and Division of Maternal-Fetal Medicine, Womack Army Medical Center, Fort Bragg, North Carolina 28310-5700, USA. Nicole.T.Yedlinsky@us.army.mil

Abstract

BACKGROUND:

Methotrexate and misoprostol are frequently used in combination for medical termination of pregnancy. Despite their frequent use, published information about low-dose exposures to these known teratogens is sparse and neonatal follow-up data are limited. We present neonatal outcomes in three infants from two different women who had failed medical terminations with methotrexate and misoprostol.

CASES:

A young gravida 1, para 0, presented with intrauterine pregnancy complicated by first-trimester exposure to oral methotrexate and vaginal misoprostol. Ultrasonography determined that the fetus had intrauterine growth restriction and ventriculomegaly. The infant had growth and developmental delays. A young gravida 4, para 3-0-0-3, also presented after first trimester exposure to methotrexate and misoprostol, and was found to have a twin gestation. The infants were noted to have multiple congenital anomalies, growth restriction, and developmental delay.

CONCLUSION:

Even single doses of methotrexate and misoprostol used in medical termination of pregnancy can be associated with multiple congenital anomalies.

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