Maternal cocaine abuse and fetal anomalies: evidence for teratogenic effects of cocaine.

We have reported the case of an infant exposed prenatally to cocaine who had congenital anomalies, adding to the growing evidence suggesting cocaine's potential for teratogenicity. The infant, born at 36 weeks' gestation, had bilateral asymmetric upper limb amputation defects. The mother had moderate to severe uterine bleeding during the second trimester of pregnancy after she used intravenous cocaine. We hypothesize that the infant's anomalies are due to cocaine embryopathy, which resulted in amnion rupture or vascular disruption. We believe that cocaine embryopathy should be considered in the differential diagnosis of infants with congenital anomalies such as limb amputation defects.