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CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2018; 05(04): 233-236
DOI: 10.1007/s40556-018-0182-2
Brief Communication

A Case of Coumarin Embryopathy After in Utero Exposure to Acenocoumarol

Ankur Singh
1   Genetic Clinic, Department of Paediatrics, Institute Of Medical Sciences, Banaras Hindu University, Uttar Pradesh, 221005, Varanasi, India
,
Astha Panghal
1   Genetic Clinic, Department of Paediatrics, Institute Of Medical Sciences, Banaras Hindu University, Uttar Pradesh, 221005, Varanasi, India
,
Rajniti Prasad
1   Genetic Clinic, Department of Paediatrics, Institute Of Medical Sciences, Banaras Hindu University, Uttar Pradesh, 221005, Varanasi, India
,
Om Prakash Mishra
1   Genetic Clinic, Department of Paediatrics, Institute Of Medical Sciences, Banaras Hindu University, Uttar Pradesh, 221005, Varanasi, India
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Abstract

Coumarins (warfarin, acenocoumarol, phenprocuomon) are well known agents that are prescribed for prevention of thromboembolic episodes in pregnant women who are on mechanical heart valves prosthesis. It acts as double edge sword as fetus is unnecessarily exposed to teratogenic effect of drug. Warfarin is well studied drug in terms of its tetratogenic dose, period of exposure, fetopathic effects. Acenocoumarol is well known teratogen but its effect and lethal dose on fetus is less reported. We report a neonate who was exposed to acenocoumarol throughout intra uterine life. Neonate showed all features of coumarin embryopathy (flat facial profile, depressed nasal bridge, short columella, skeletal stippling, short distal phalanges in hand) and cephalhaematoma in addition. We also summarised the clinical findings of all the cases reported so far of acenocoumarol embryopathy. Acenocoumarol has same teratogenic potential as of warfarin. Doses causing embryopathy remained unexplored field. Clinicians need to document properly so that scientific data can be generated as ethical issues arises in head to head trial of these drugs.

Keywords

Acenocoumarol - Embryopathy - Chondrodysplasia - Calcification - Mid face hypoplasia


Publication History

Received: 15 April 2018

Accepted: 09 July 2018

Article published online:
08 May 2023

© 2018. Society of Fetal Medicine. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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