低剂量母体服用华法林导致胎儿华法林综合征：探寻孕期安全的抗凝方案。
Low-dose maternal warfarin intake resulting in fetal warfarin syndrome: In search for a safe anticoagulant regimen during pregnancy.
作者信息
Basu Sriparna, Aggarwal Priyanka, Kakani Neha, Kumar Ashok
机构信息
Neonatology Unit, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
出版信息
Birth Defects Res A Clin Mol Teratol. 2016 Feb;106(2):142-7. doi: 10.1002/bdra.23435. Epub 2015 Sep 21.
BACKGROUND
Fetal exposure to maternal ingestion of warfarin is known to produce certain dysmorphic features in the neonate, known as fetal warfarin syndrome (FWS). There is a general consensus that maternal intake of warfarin at a daily dose of 5 mg or less is safe both for the infant and the mother.
METHODS
We report four cases of FWS born to mothers with rheumatic heart disease on warfarin prophylaxis during pregnancy at a dose less than 5 mg/day.
RESULTS
Along with typical facial features of FWS and multiple epiphyseal stippling in skeletal x-ray, Case 1 had Dandy-Walker malformation and Case 2 had laryngo-tracheomalacia and patent ductus arteriosus.
CONCLUSION
We emphasize the need for optimizing the choice and dosage schedule of anticoagulants during pregnancy, least harmful for the mother and her developing fetus.
背景
已知胎儿在母体摄入华法林后会出现某些新生儿畸形特征，即胎儿华法林综合征（FWS）。普遍的共识是，母亲每日服用5毫克或更低剂量的华法林对婴儿和母亲都是安全的。
方法
我们报告了4例患有风湿性心脏病的母亲在孕期服用低于5毫克/天剂量的华法林进行预防治疗后所生的FWS病例。
结果
除了FWS典型的面部特征和骨骼X线检查显示的多发骨骺点状钙化外，病例1患有Dandy-Walker畸形，病例2患有喉气管软化症和动脉导管未闭。
结论
我们强调在孕期需要优化抗凝剂的选择和用药方案，使其对母亲及其发育中的胎儿危害最小。
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