1/9. Cervical teratoma.Cervical teratomas are rare tumors in an unusual location. A neck mass in a newborn was excised when it enlarged disproportionately; histologically, it was a teratoma. Teratomas may occur because of an alteration in sterol chemistry; conception in this case occurred while the mother was ingesting estrogens. Retinal tissue, an unusual finding, was present in this teratoma. Symptoms in cervical teratomas are secondary to interference with deglutition and respiration. Treatment is surgical excision.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
2/9. Mobius sequence in children exposed in utero to misoprostol: neuropathological study of three cases.BACKGROUND: misoprostol exposure in the first trimester of pregnancy has been related to congenital malformations, particularly the Mobius sequence and terminal transverse limb defects. CASES: Neuropathological findings of three patients with Mobius sequence related to misoprostol are reported. No previous pathological studies have shown these abnormalities to be associated with misoprostol exposure in utero. The brain stem was cut serially, from the rostral mesencephalum to the caudal aspect of the medulla, and all fragments were stained with hematoxylin-eosin and cresyl violet. Old ischemic-anoxic foci of gliosis, with necrosis and calcification, dorsally situated, were present from the pons to the medulla, involving some cranial nerve nuclei (especially the IV, VII, and XII) that were partially or completely depopulated of neural cells. CONCLUSIONS: The findings suggest a circulatory mechanism to the Mobius sequence, with vascular disruption involving the territory of the subclavian artery, occurring in a critical period of embryonic life between six to eight weeks postconception. These cases add further evidence of the role of misoprostol as a teratogen.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
3/9. Mycophenolate mofetil in pregnancy after renal transplantation: a case of major fetal malformations.BACKGROUND: Mycophenolate mofetil has teratogenic properties in rats and rabbits. Previous human studies have reported an increased rate of fetal losses with its use. We report a case of major fetal malformations due to mycophenolate mofetil. CASE: The patient was treated with mycophenolate mofetil before conception and during the first trimester of pregnancy. The fetus had multiple malformations, specifically, facial dysmorphology and midline anomalies, including agenesis of the corpus callosum. CONCLUSION: This case of fetal malformation attributable to mycophenolate mofetil must be taken into consideration when considering pregnancy in an organ-transplant recipient.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
4/9. Combined chemotherapy and teratogenicity.BACKGROUND: The concomitant occurrence of breast cancer and pregnancy is relatively uncommon. We report the case of a patient with syndactyly, cleft hands, and absence of distal finger phalanges associated with maternal exposure to chemotherapeutic agents during the first trimester of pregnancy. These associations have not been previously described. CASE: The patient was born by normal delivery after 38 weeks of pregnancy. His mother became pregnant while receiving chemotherapy (cyclophosphamide, 5-fluorouracil, and adriamycin) for breast cancer, and the fetus was exposed to these drugs from conception to the 16th week of pregnancy. At birth, anomalies were observed, including a high-arched palate, microcephaly, a flat nasal bridge, bilateral syndactyly in the first and second fingers with a hand cleft between the second and third fingers and hypoplasia of the fifth fingers, and dystrophic nail of the fourth finger of the left hand. The patient's growth and development were deficient. CONCLUSIONS: The malformations associated with in utero exposure to these chemotherapeutic agents are highly variable, but growth deficiency and anomalies of the craniofacial region and limbs are the most common. The pattern of malformations in children who were congenitally exposed to chemotherapeutic agents appears to be directly related to the age at and duration of exposure, rather than to the specific drug itself. Effective contraception is essential for the safe use of a potential teratogen in nonpregnant women of reproductive age.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
5/9. A case of partial sirenomelia and possible vitamin a teratogenesis.Prenatal echographical findings of a partial sirenomelic fetus are described. An attempt was made to terminate pregnancy by administration of prostaglandin F2 alpha, but uterine rupture occurred. The teratogenic role of vitamin a ingested by the mother in the periconceptional period is discussed.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
6/9. Successful pregnancy following continuous treatment with combination chemotherapy before conception and throughout pregnancy.A 21-year-old woman with diffuse histiocytic lymphoma received combination chemotherapy continuously for 16 months before conception and throughout pregnancy. procarbazine and BCNU were given for 5 months before conception and throughout the first and second trimesters, and streptozotocin was given throughout the third trimester. A male infant who was phenotypically and genotypically normal was delivered. The authors reviewed the literature regarding chemotherapeutic agents given during the first trimester of pregnancy. Although most chemotherapeutic agents are teratogenic in the animal model, the incidence of teratogenicity of chemotherapeutic agents given to humans in the first trimester of pregnancy is 12.7%. This represents a fivefold increase in teratogenicity. As yet the administration of chemotherapeutic agents in the second and third trimesters has not resulted in teratogenicity. This information may help the physician when deciding whether to treat pregnant patients with chemotherapeutic agents during the first trimester or whether to continue treatment when the patient has become pregnant while receiving these agents.- - - - - - - - - - ranking = 6keywords = conception (Clic here for more details about this article) |
7/9. Teratogenic effects in a case of maternal treatment for acute myelocytic leukaemia--neonatal and infantile course.Experience with the use of cytotoxic drugs in the first trimester of pregnancy is limited. We report on the clinical phenotype and infantile development of a girl born to a 36-year-old mother. Before recognition of pregnancy, the latter had been treated for acute myelocytic leukaemia receiving cytarabine, daunorubicin and doxorubicin at conception and cytarabine and thioguanine at about 35-37 days post conception. At delivery, there were severe brachycephaly, hypoplasia of the anterior cranial base and the midface as well as synostoses of both coronal and metopic sutures. Further findings included bilateral four-finger hands with hypoplastic thumbs and absent radii. This phenotype is reminiscent of the Baller-Gerold syndrome. The child, at present 15 months old, has had to undergo two operations for fronto-orbital advancement because of insufficient growth of the mid-face, nasal airway hypoplasia and increased intracranial pressure. Motor milestones are slightly retarded--neurodevelopment is otherwise normal. These findings are discussed in the context of the few previous reports and are particularly important for future genetic counselling.- - - - - - - - - - ranking = 2keywords = conception (Clic here for more details about this article) |
8/9. Megadose carbamazepine during the period of neural tube closure.BACKGROUND: Analyses of the frequency of congenital anomalies among infants born to women who used carbamazepine during organogenesis have not yielded consistent results. Because the drug is used to treat epilepsy, any association is confounded by the underlying condition. CASE: A nonepileptic 44-year-old multigravid woman attempted suicide by ingesting 24 200-mg carbamazepine tablets (approximately 4.8 g). By last menstrual period and sonogram dates, the megadose occurred during the third to fourth week post-conception. Maternal drug levels were elevated above therapeutic ranges for 2 days. Maternal serum alpha-fetoprotein was elevated, and high-resolution fetal sonography demonstrated a large myeloschisis that was verified at autopsy. No family history of neural tube defects or any other malformations was reported by the patient. Megadose carbamazepine ingestion during the period of neural tube closure was the only known risk factor. CONCLUSION: Although no other published reports of megadose carbamazepine during pregnancy were located, the neural tube defect is consistent with the recently reported risks for congenital anomalies in infants born to women who used this anticonvulsant in therapeutic doses during pregnancy.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
9/9. adult and two children with fetal methotrexate syndrome.The folic acid antagonists, methotrexate and aminopterin, are known to be teratogenic in humans. The critical period for their teratogenecity is suspected to be between 6 to 8 weeks post-conception. Fetal exposure from 10 to 32 weeks weeks post-conception to methotrexate alone or in combination with other anti-cancer drugs has not resulted in obvious teratogenic effects. methotrexate is often used to treat cancers but is occasionally used as an abortifacient. The long-term outcome of the fetal aminopterin syndrome has been published in only four adults. We report on a 28-year-old man with fetal methotrexate syndrome and two children with mild manifestations of the syndrome. One child was inadvertently exposed to methotrexate from 7 1/2 through 30 weeks post-conception because his mother was receiving it for treatment of breast cancer. The other was exposed from 11 weeks and 5 days through 25 weeks in an attempt to induce abortion. The 28-year-old man has craniofacial and digital anomalies, growth retardation but normal intelligence as noted in the previously reported cases. These cases remind us of the teratogenicity of methotrexate and should serve as a warning that if methotrexate is used as an abortifaciant and an abortion does not ensue, there is a teratogenic risk.- - - - - - - - - - ranking = 3keywords = conception (Clic here for more details about this article) |