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Federación Mexicana de Ginecología y Obstetricia, A.C.
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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
Full text How to cite this article

Language: Spanish
References: 25
Page: 140-146
PDF size: 242.92 Kb.


Key words:

Moebius syndrome, Prenatal exposure to misoprostol, Misoprostol in the first trimester.

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.


REFERENCES

  1. Sánchez-Rodríguez G, et al. Malformaciones congénitasasociadas al uso de misoprostol: Reporte de dos casos.Rev Mex Neuroci 2013; 14 (1): 50-53.

  2. Pastuszak A, et al. Use of misoprostol during pregnancy andMobius syndrome in infants. N Engl J Med 1998; 338 (26):1881-5. doi: 10.1056/NEJM199806253382604

  3. Tang O, et al. Misoprostol: Pharmacokinetic profiles, effectson the uterus and side-effects. Int J Gynecol Obstet 2007;99, S160-S167. doi:10.1016/j.ijgo.2007.09.004

  4. Vargas F, et al. Prenatal exposure to misoprostol andvascular disruption defects: A Case-Control Study.Am J Med Genet 2000; 95 (4): 302-6. doi: 10.1002/1096-8628(20001211)95:4<302::aid-ajmg2>3.0.co;2-b

  5. Gaglioti P, et al. The significance of fetal ventriculomegaly:etiology, short and long term-outcomes. Prenat Diagn2009; 29: 381-88. doi: 10.1002/pd.2195

  6. Gaglioti P, et al. Fetal cerebral ventriculomegaly: outcomein 176 cases. Ultrasound Obstet Gynecol 2005; 25 (4):372-77. doi:10.1002/uog.1857

  7. Boss-Thompson M, et al. Moebius syndrome in a neonate afterMifepristone and Misprostol elective abortion failure. Annalsof Pharmacotherapy 2008; 42. doi: 10.1345/aph.1K550

  8. Breeze ACG, et al. Obstetric and neonatal outcomes inapparently isolated mild fetal ventriculomegaly. J PerinatMed 2005; 33: 236-40. https://doi.org/10.1515/JPM.2005.043

  9. Vergani P, et al. Clinical outcome of mild fetal ventriculomegaly.Am J Obstet Gynecol 1998;178: 218-22. https://doi.org/10.1016/S0002-9378(98)80003-3

  10. Griffiths P, et al. A prospective study of fetuses with isolatedventriculomegaly investigated by antenatal sonographyand in utero MR imaging. AJNR Am J Neuroradiol 2010;31: 106–111. doi:10.3174/ajnr.A1767

  11. Pagani G, et al. Neurodevelopmental outcome in isolatedmild fetal ventriculomegaly: systematic review and metaanalysis.Ultrasound Obstet Gynecol 2014; 44 (3): 254-60PMID 24623452

  12. Achiron R, et al. Fetal mild idiopathic lateral ventriculomegaly:is there a correlation with fetal trisomy? UltrasoundObstet Gynecol 1993; 3 (2): 89. PMID 1279729

  13. Norton M, et al. Fetal cerebral ventriculomegaly. Apr 08,2021. www.uptodate.com

  14. Society for Maternal-Fetal Medicine (SMFM). Mild fetalventriculomegaly: diagnosis, evaluation, and management.Am J Obstet Gynecol 2018; 219 (1): B2. PMID 29705191

  15. Pisapia J, et al. Fetal ventriculomegaly: Diagnosis,treatment, and future directions. Childs Nerv Syst 2017;33: 1113-1123. doi:10.1007/s00381-017-3441-y

  16. Adam MP, Pagon RA, Wallace SE. Gene Reviews. Universityof Washington, Seattle 1993-2022. PMID: 20301295

  17. Tanchi P, et al. Carey-Fineman-Ziter syndrome: a spectrumof presentations. Case Rep Perinat Med 2012; 1 (1-2): 99-102. doi: 10.1515/crpm-2012-0028

  18. Chicarilli Z, et al. Oromandibular Limb Hypogenesis Syndrome.Plastic and Reconstructive Surgery 1985; 76 (1).doi: 10.1097/00006534-198507000-00003

  19. Castelino R, et al. Oromandibular-limb hypogenesis syndrometype II C: A rare case. J Dent Res Dent Clin DentProspects 2010; 4 (4): 136-39. PMC3429967

  20. Jabbour H, et al. Prostaglandin receptor signalling andfunction in human endometrial pathology. TRENDS in Endocrinologyand Metabolism 2004; 15 (8). doi:10.1016/j.tem.2004.08.006

  21. Bell C, et al. Will the real Moebius syndrome please standup? A systematic review of the literature and statisticalcluster analysis of clinical features. Am J Med Genet. 2019;179A: 257-65. doi: 10.1002/ajmg.a.60683

  22. Slee J, et al. Deletion of chromosome 13 in Moebius syndrome.J Med Genet 1991; 28: 413-14.

  23. Matsui K, et al. Clinical Characteristics and outcomes ofMöbius Syndrome in a Children’s Hospital. Pediatric Neurology2014; 51: 781e789. http://dx.doi.org/10.1016/j.pediatrneurol.2014.08.011

  24. Gonzalez CH, et al. Limb deficiency with or without Möbiussequence in seven Brazilian children associated withmisoprostol use in the first trimester of pregnancy. Am JMed Genet 1993; 47: 59-64.

  25. Silva Dal Pizzol T, et al. Prenatal exposure to misoprostoland congenital anomalies: Systematic review and metaanalysis.Reproductive Toxicology 2006; 22: 666-71. doi:10.1016/j.reprotox.2006.03.015




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Ginecol Obstet Mex. 2023;91