A case of warfarin embryopathy / 대한주산의학회잡지

ABSTRACT

Warfarin is an oral anticoagulant which is known to cross the placenta causing birth defects, known as warfarin embryopathy; fetal effects of early gestational exposure to warfarin is known to cause marked nasal hypoplasia, rhizomelia, and stippled epiphyses. The period of greatest sensitivity is 6 to 9 weeks of gestational age. Clinical studies have suggested that discontinuing warfarin before 6 weeks of gestational age could avoid the teratogenic effect. We experienced a women who had been taking warfarin for 15 years because of SLE (Systemic Lupus Erythematosus) and CRF (Chronic renal failure), who was found to be pregnant at 9 weeks of gestation. She discontinued warfarin and started heparin treatment, however the ultrasound examination showed shortened long bone, scalp edema, and cardiac anomaly (Ventricular septal defect), and termination of pregnancy was performed at 17 weeks of gestation. We report a case of warfarin embryopathy resulting from warfarin exposure until 9 weeks of gestation with a brief review of literature.