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Flashcards in Teratology Deck (17):
1

Most common fetal anomaly from cyclophosphamide?

Missing or hypoplastic digits

2

What are the fetal effects of ACE inhibitors?

No structural malformations from first trimester exposure have been noted.
Most commonly there is late-onset growth restriction and oligo followed by profound and prolonged neonatal hypotension and anuria.
The most severe consequence is renal tubular dysgenesis which causes early onset oligo, pulmonary hypoplasia and limb contractures.
Hypocalvaria is also strongly linked to ACE inhibitor exposure.

3

Which of the following medications are contraindicated in breastfeeding?

Cyclosporine, PTU - ok, Warfarin, Phenytoin

4

Anticonvulsants that should be avoided in pregnancy, at least in first trimester

Valproic acidPhenytoinCarbamazepinePhenobarbitalTopiramatePrimidoneTrimethadione

5

Overall rate of major fetal malformations with phenobarbital

6.00%

6

Overall rate of major fetal malformations with lamotrigine

3.00%

7

Overall rate of major fetal malformations with carbamazepine

3.00%

8

Fetal malformations associated with carbamazepine

CraniofacialFingernail hypoplasiaDevelopmental delayNeural tube defects

9

Overall rate of major fetal malformations with valproic acid

10.00%

10

Fetal malformations associated with valproic acid

Neural tube defects (1-2%)Cleft lip/palateDevelopmental delayHypospadiasCardiac malformationsEndocrine disorders

11

Fetal malformations associated with phenytoin

Fetal hydantoin syndrome:Prenatal & postnatal growth deficiencyMicrocephalyDysmorphic faciesMental deficiencyCleft lip/palate

12

How common is fetal hydantoin syndrome

May be seen in 11% of infants exposed to phenytoin in utero, but 30% may have lesser degrees of impairment

13

Fetal malformations associated with topiramate

Oral cleftsIncreased risk of low birth weight

14

Fetal malformations associated with lamotrigine

Facial clefts

15

Which is more teratogenic: valproic acid or carbamazepine?

Valproic acid

16

Valproic acid + ___ is particularly teratogenic.

Lamotrigine

17

Is breastfeeding contraindicated in women taking anticonvulsants?

No. Monitor infants for sedation. Valproic acid, phenobarbital, phenytoin, and carbamazepine may be considered as not transferring into breast milk as much as levetiracetam, gabapentin, lamotrigine, and topiramate.