| Pregnancy Outcome after Exposure of Suspected Teratogens in Early Pregnancy. |
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Hae Suk Kim, Jung Yeol Han, Su Hyun Park, Hye Jin Cho, Ha Jung Lim, Myoung Jin Moon, Jin Hoon Chung, June Seek Choi, Hyun Kyung Ahn, Hyun Mee Ryu, Moon Young Kim, Joo Oh Kim, Joong Sik Shin, Kyu Hong Choi, Jae Hyug Yang |
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Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, SungKyunKwan University, School of Medicine, Seoul, Korea. |
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| Abstract |
OBJECTIVE
To compare the risk of congenital anomaly after exposure to suspected teratogens in early pregnancy with the known baseline risk to the geneneral population. METHODS: From September 1999 to August 2001, we counseled about the teratogenic risk of the fetus by relevant medical literatures after assessment of type, amount, and time of exposure for 302 pregnant women exposed to suspected teratogens such as drugs, radiation, alcohol, and cigarette smoking. We followed up on the pregnancy outcome with the rate of termination of pregnancy and incidence of congenital anomaly. RESULTS: Among a total of 302 cases, 253 pregnant women (83.8%) delivered, 15 (5%) were aborted spontaneously, 34 (11.3%) were terminated. 297 pregnant women (98.3%) were lastly exposed to drugs in mean 5.3 +/- 0.2 gestational weeks. Medicines taken were gastrointestinal drugs (23%), NSAIDs (18.3%), antibiotics (16.2%), antihistamines (10.8%) in the order of frequency. 74 pregnant women (24.5%) were exposed to radiation in mean 5.1 +/- 0.5 gestational weeks. The mean dose was 234.60 mrem. 113 pregnant women (37.3%) lastly drank alcohol in mean 4.5 +/- 0.4 gestational weeks and the mean amount was 1.55 oz. 36 pregnant women (11.9%) lastly smoked in mean 4.4 +/- 0.3 gestational weeks and the mean amount was 7.3 cigarettes/day. We found structural anomalies in 5 cases (Polydactylyl, Ileal agenesis, Both ear mass, Left ectopic kidney, Meningomyelocele) and 1 chromosomal abnormality case (Trisomy18). CONCLUSION: The rate of fetal structural anomaly was 2% in this study and is not more than baseline risk of general population. Therefore, evidence-based teratogenic risk counseling may prevent unnecessary pregnancy termination. |
| Key Words:
Fetal anomaly, Suspected teratogen, Termination of pregnancy |
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