Gonzalez, Claudette Hajaj; Marques-Dias, Maria Joaquina; Kim, Chong Ae; Sugayama, Sofia MM.; Da Paz, José Albino; Huson, Susan M.; Holmes, Lewis B.

Congenital abnormalities in Brazilian children associated with misoprostol misuse in first trimester of pregnancy
Gonzalez, Claudette Hajaj; Marques-Dias, Maria Joaquina; Kim, Chong Ae; Sugayama, Sofia MM.; Da Paz, José Albino; Huson, Susan M.; Holmes, Lewis B. - 1998 - Lancet, 351, 9116, 1624-7

Mots clés : avortement provoqué; biologie; contraception d'urgence; échec d'avortement; éducation au planning familial; effets secondaires; étude de cas; études; fotus; grossesse; maladie et malformation congénitales; maladies; maladies congénitales; malformations congénitales; médicament abortif; méthodes d'avortement; méthodologie; misoprostol; physiologie; planification familiale; planning familial; prostaglandines; reproduction
Pays / Régions : Amérique du Sud; Amérique latine; Brésil; Pays en développement

Résumé : In Brazil and other South and Central American countries where abortion is illegal, misoprostol is widely available and commonly used to induce abortion. However, misoprostol is not very effective as an abortifacient agent and can cause fetal abnormalities. The present study reviewed the cases of 42 infants from Sao Paulo, Brazil, who were exposed to misoprostol during the first trimester of pregnancy and then born with a congenital abnormality. 17 children had equinovarus with cranial nerve deficiencies and 10 had equinovarus as part of a more extensive arthrogryposis. The most distinctive phenotypes were arthrogryposis confined to the legs (5 cases) and terminal transverse limb defects (9 cases). Congenital hydrocephalus was present in 8 children. The most commonly taken dose of misoprostol was 800 mcg (range, 200-16,000 mcg). Greater awareness of the widespread use of misoprostol to induce abortion should lead to public health interventions to prevent teratogenic effects.

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