Terminal transverse limb defects with tethering and omphalocele in a 17 week fetus following first trimester misoprostol exposure.
We report a fetus from an elective termination at 17 weeks gestation following maternal ingestion of 1200 micrograms of misoprostol at 7 weeks of gestation. The fetus had abscence of the middle and distal phalanges of fingers 1, 3, 4 and 5 with tethering by thin strands of tissue on one hand, a below-knee amputation of one leg and omphalocele. There was absence of amnion on the chorionic surface of the placenta, a pathologic feature of early amnion rupture. The association in this case of the phenotypic features of the amniotic band syndrome suggests that the teratogenicity of misoprostol at 9 to 12 weeks gestation can overlap that of other acute insults at that time, such as chorionic villus sampling, dilatation and curettage and abdominal trauma in the first trimester.
D000014:Abnormalities, Drug-Induced; D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects*; D000328:Adult; D005260:Female; D006554:Hernia, Umbilical / Q000139:chemically induced*; D006801:Humans; D017880:Limb Deformities, Congenital / Q000139:chemically induced*; D016595:Misoprostol / Q000009:adverse effects*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016216:Ultrasonography, Prenatal