Rischbieth R H
Clin Exp Neurol. 1979;16:251-6.
It has long been known or suspected that phenytoin and probably phenobarbitone prescribed in pregnancy may lead to fetal malformations. The use of troxidone for epileptic women during pregnancy was reported in 1970 to lead to malformations. Over 50 instances of pregnancy in women taking troxidone have since been reported. In 8 of these the drug was used alone. 13 pregnancies resulted in abortion and 33 of the 40 survivors had a minor congenital anomaly, leading to death in 14. Complex congenital heart lesions with patent ductus, septal defects and aortic hypoplasia were apparent in half the survivors. Malformed or low-set ears were seen in nearly half the cases, palatal deformities were less common and evidence intrauterine growth retardation was frequently present. A 29-year-old mother taking troxidon and carbamazepine, and with a history of hypertension and proteinuria dating back to adolescence, delivered her first child prematurely. The child was small, showed deformed ears, displayed feeding problems and was found to be in cardiac failure with a systolic murmur and absent femoral pulses. Postnatal growth was retarded and after further cyanotic attacks a cardiac catheter study was performed. This showed a hypoplastic aortic arch with an anomolous origin of the left subclavian artery and patent ductus arteriosus, findings similar to those previously reported in neonates following maternal use of troxidone.
长期以来人们已知或怀疑，孕期使用苯妥英钠以及可能还有苯巴比妥可能会导致胎儿畸形。1970年有报告称，癫痫女性孕期使用三甲双酮会导致畸形。此后又报告了50多例服用三甲双酮的女性怀孕的情况。其中8例仅使用了该药物。13次妊娠以流产告终，40名存活者中有33名有轻微先天性异常，其中14名死亡。半数存活者有伴有动脉导管未闭、室间隔缺损和主动脉发育不全的复杂先天性心脏病变。近半数病例可见耳部畸形或低位耳，腭裂畸形较少见，且常有宫内生长迟缓的迹象。一名29岁的母亲服用三甲双酮和卡马西平，有高血压和蛋白尿病史，可追溯到青春期，她早产下第一个孩子。孩子体型小，耳朵畸形，有喂养问题，被发现患有心力衰竭，有收缩期杂音且股动脉搏动消失。出生后生长发育迟缓，在进一步出现青紫发作后进行了心导管检查。结果显示主动脉弓发育不全，左锁骨下动脉起源异常，动脉导管未闭，这些发现与此前报告的母亲使用三甲双酮后新生儿的情况相似。
