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- Title
Coumarin embryopathy in an extremely low birth weight infant associated with neonatal hepatitis and ocular malformations.
- Authors
Hetzel, Patrick G.; Glanzmann, René; Hasler, Pascal W.; Ladewick, Ariane; Bührer, Christoph; Glanzmann, René; Bührer, Christoph
- Abstract
Coumarin embryopathy (CE) is a well-documented sequelae of prenatal exposure to vitamin K antagonists. We report on a female premature infant (25 weeks' gestation) born to a mother who had received phenprocoumon during pregnancy following mechanical heart valve replacement. The infant presented with impaired coagulation, intraventricular and minor parenchymal cerebral haemorrhages and midface hypoplasia typical of CE. In addition, there was hepatopathy with conjugated hyperbilirubinemia, elevated liver enzymes and repeated episodes of hypoglycemia upon attempts to discontinue glucose supplementation, all lasting for 4 months. There was corneal opacity with anterior segment dygenesis in the left eye, and persistent pupillary membrane, cataract and persistent hyperplastic primary vitreous in the right eye. While liver disease is an uncommon but serious side effect of vitamin K antagonists, this is the first report describing neonatal hepatopathy as part of CE. In anticoagulation of pregnant women with mechanical heart valves, vitamin K antagonists should be used with utmost restraint.
- Subjects
COUMARINS; FETAL diseases; NEONATAL hepatitis; CATARACT; VITAMIN K; FACIAL abnormalities; THROMBOEMBOLISM prevention; ANTICOAGULANTS; LOW birth weight; CARDIOVASCULAR diseases in pregnancy; EYE abnormalities; PROSTHETIC heart valves; INFECTIVE endocarditis; DRUG-induced abnormalities; CORNEAL opacity
- Publication
European Journal of Pediatrics, 2006, Vol 165, Issue 6, p358
- ISSN
0340-6199
- Publication type
journal article
- DOI
10.1007/s00431-005-0064-1