2023, Number 02
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Ginecol Obstet Mex 2023; 91 (02)
Disruptive congenital anomalies associated with misoprostol. Case report
Villagómez-Mendoza EA, Acevedo-Gallegos S, Gallardo-Gaona JM, Velázquez-Torres B; Ramírez-Calvo JA, Aguinaga-Ríos M
Language: Spanish
References: 25
Page: 140-146
PDF size: 242.92 Kb.
ABSTRACT
Background: Prenatal misoprostol exposure can be associated with a spectrum of
birth defects, ranging from central nervous system abnormalities, Moebius sequence,
abdominal wall defects, as well as transverse limb defects, fetal abnormalities are more
commonly seen with the use of the misoprostol-only regimen for induction of abortion,
such that a thorough medical history is essential to detect a history of prenatal
exposure after a failed abortion.
Clinicai case: A 21-year-old patient, with a 32-week pregnancy, who attended the
institute with a diagnosis of a fetus with ventriculomegaly, the ultrasound evaluation
highlighted severe symmetric triventricular ventriculomegaly and angulation of both
lower extremities in varus, magnetic resonance imaging reported severe non-communicating
ventriculomegaly Symmetric bilateral, due to probable stenosis of the aqueduct
of Silvio, the karyotype reported 46, XY, as well as a negative TORCH profile, however,
a cesarean section was performed for fetal indication at 35 weeks, the evaluation at
birth showed bilateral facial paralysis, macrocephaly and foot Bilateral equinus varus,
upon re-examination the patient referred the use of misoprostol in the first trimester
of pregnancy for abortive purposes, so as there were no chromosomal or infectious
alterations, a Moebius sequence was suggested.
Conclusions: Prenatal exposure to misoprostol is related to the appearance of
vascular disruption defects in some exposed fetuses, the precise spectrum and potential
estimation of teratogenicity have not yet been determined, the clinical history is the
mainstay for the association in these cases.
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