Résumé : Recent data from Brazil, where misoprostol is used widely as an abortifacient and available over the counter, have suggested a relationship between unsuccessful first-trimester use of this prostaglandin and Moebius syndrome (congenital facial paralysis). To confirm or refute such an association, the frequency of misoprostol use was assessed in the mothers of all 96 infants with Moebius syndrome born in 1990-96 at 7 hospitals in Brazil; mothers of 96 matched infants with neural tube defects were enrolled as controls. There were no significant differences between the two groups of mothers in terms of education, gravidity, parity, number of previous miscarriages or induced abortions, smoking, or alcohol consumption during pregnancy. 47 mothers (49%) in the Moebius syndrome group, compared with only 3 (3%) in the neural tube defect group, reported misoprostol use during the first trimester of the index pregnancy (odds ratio, 29.7; 95% confidence interval, 11.6-76.0). 20 mothers of infants with Moebius syndrome had taken misoprostol orally and 20 had taken the drug both orally and vaginally. The mean misoprostol dose was 842 +or- 543 mcg; in Brazil, each misoprostol capsule contains 200 mcg. 33 mothers of Moebius syndrome infants reported vaginal bleeding after taking misoprostol. These findings confirm a strong association between prenatal misoprostol use and Moebius syndrome. The syndrome may be related to vascular disruption of the subclavian artery during weeks 4-6 of embryonic development or to an ischemic event in the embryonic brain stem.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 135094