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Embryofetopathy due to oral anticoagulant therapy

Synonym(s) Coumarin embryopathy
Fetal warfarin syndrome
Vitamin K antagonists embryofetopathy
Prevalence Unknown
Inheritance Not applicable
Age of onset Neonatal
  • Q86.2
MeSH -
  • 10051445


Disease definition

Embryofetopathy due to oral anticoagulant therapy is characterized by a group of symptoms that may be observed in a fetus or newborn when the mother has taken oral vitamin K antagonists, such as warfarin (coumadin) during pregnancy. Vitamin K antagonists are anticoagulant drugs that provide efficient thromboprophylaxis and that can cross the placenta. 5-12% of infants exposed to warfarin between 6-9 weeks gestation present nasal hypoplasia and skeletal abnormalities, including short limbs and digits (brachydactyly), and stippled epiphyses. Warfarin fetopathy with central nervous system abnormalities (hydrocephalus, intellectual disability, spasticity, and hypotonia) or ocular abnormalities (microphthalmia, cataract, optic atrophy), fetal loss, and stillbirth, occurs in infants exposed at later gestations. Additional features that have been reported after in utero warfarin exposure include facial dysmorphism (cleft lip and/or palate, malformed ears), choanal atresia or stenosis, aorta coarctation, situs inversus totalis (see these terms), bilobed lungs, ventral midline dysplasia.

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