Wheeler Marsha, O'Meara Patrick, Stanford Michelle
Denver Health Medical Center, Department of Obstetrics and Gynecology, Department of Pediatrics, Denver, Colorado 80204, USA.
Teratology. 2002 Aug;66(2):73-6. doi: 10.1002/tera.10052.
Fetal aminopterin/methotrexate syndrome was described nearly 50 years ago when these agents were first used as abortifacients. Physicians essentially stopped using these agents when the associated anomalies were recognized. Over the last several years the use of methotrexate with or without misoprostol for management of ectopic pregnancy and medical terminations of pregnancy has increased.
A 23-year-old female sought a termination at eight weeks gestation. She was given methotrexate followed by misoprostol.
The medical termination was unsuccessful. The patient elected to continue the pregnancy secondary to financial considerations. She presented at 39 weeks without intervening prenatal care. She was diagnosed with severe preeclampsia. At delivery the infant was hypotonic and growth restricted with multiple anomalies.
Physicians are increasingly using methotrexate with or without misoprostol for treatment of ectopic pregnancies and medical terminations. Clinicians need to be aware of the characteristic teratologic effects of these two agents.
胎儿氨甲蝶呤/甲氨蝶呤综合征在近50年前被首次描述，当时这些药物最初被用作堕胎药。当认识到相关异常情况时，医生基本上停止了使用这些药物。在过去几年中，甲氨蝶呤联合或不联合米索前列醇用于治疗异位妊娠和药物终止妊娠的情况有所增加。
一名23岁女性在妊娠8周时寻求终止妊娠。她接受了甲氨蝶呤治疗，随后服用了米索前列醇。
药物流产未成功。由于经济原因，患者选择继续妊娠。她在39周时就诊，未接受产前检查。她被诊断为重度子痫前期。分娩时，婴儿肌张力低下且生长受限，伴有多种畸形。
医生越来越多地使用甲氨蝶呤联合或不联合米索前列醇来治疗异位妊娠和进行药物流产。临床医生需要了解这两种药物的典型致畸作用。
