Heckel S, Favre R, Weber P, Dellenbach P
C.M.C.O.-Schiltigheim, Strasbourg.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(1):43-7.
Retinoids are vitamin A derivatives used in dermatology. One of them, isotretinoin, is frequently prescribed for refractory juvenile acne. The teratogenetic power of this drug is substantial, being estimated at 15 to 45% of exposures in utero. The risk is maximum in the first trimester of pregnancy and persists up to one month after treatment has been discontinued. The most frequently described multiple malformation syndrome involves the face, the central nervous system and the heart. There is also a 20 to 30% rate of spontaneous abortion. The authors report a case where exposure during the first trimester did not result in foetal malformation. From a full review of the literature the various malformations observed, the presumed mechanisms of teratogenesis and the strict rules of prescription and surveillance in women child-bearing age are presented. The problem of the measures to be taken in case of retinoid treatment during pregnancy is discussed. The teratogenic risk from other retinoids is dealt with.
维甲酸是用于皮肤科的维生素A衍生物。其中一种，异维甲酸，常用于治疗难治性青少年痤疮。这种药物的致畸作用很大，据估计，子宫内接触该药物后致畸率为15%至45%。怀孕头三个月的风险最大，且在停药后持续长达一个月。最常描述的多重畸形综合征涉及面部、中枢神经系统和心脏。自然流产率也为20%至30%。作者报告了一例在孕早期接触该药物但未导致胎儿畸形的病例。通过全面回顾文献，介绍了观察到的各种畸形、推测的致畸机制以及育龄妇女严格的处方和监测规则。讨论了怀孕期间进行维甲酸治疗时应采取的措施问题。还探讨了其他维甲酸的致畸风险。
