Document Detail

High-dose methotrexate during pregnancy: risk of malformations.
MedLine Citation:
PMID:  21180376     Owner:  NLM     Status:  MEDLINE    
Methotrexate is a cytotoxic and immunosuppressant drug mainly used in oncology and rheumatology. It is sometimes used at high doses to treat unruptured ectopic pregnancy. Methotrexate is teratogenic. Malformations reported after exposure in utero include: abnormalities of the skull and face, limb defects, failure of ossification, and congenital cardiopathy.The risk of malformations is probably dose-dependent and seems to be relatively low at the low weekly doses used in rheumatology. Three cases of malformations have been reported after failure of high-dose methotrexate in pregnancies that were misdiagnosed as ectopic. Two newborns had scoliosis, facial dysmorphism, limb malformations, or cardiopathy.The third newborn had minor malformations. In practice, high-dose methotrexate must only be used to treat ectopic pregnancy if the diagnosis has been confirmed. The woman should be informed of the risks to her unborn child in case of diagnostic error or treatment failure.
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prescrire international     Volume:  19     ISSN:  1167-7422     ISO Abbreviation:  Prescrire Int     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9439295     Medline TA:  Prescrire Int     Country:  France    
Other Details:
Languages:  eng     Pagination:  212-3     Citation Subset:  T    
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MeSH Terms
Abnormalities, Drug-Induced / etiology*
Folic Acid Antagonists / adverse effects*
Methotrexate / adverse effects*
Pregnancy, Ectopic / drug therapy*
Treatment Failure
Reg. No./Substance:
0/Folic Acid Antagonists; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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