title: Fetal exposure to isotretinoin-an international problem.
abstract: BACKGROUND
  Isotretinoin is a known teratogen. Pregnancy prevention programs aimed at minimizing isotretinoin exposure in pregnancy have been implemented in North America with limited success.
  
  
  OBJECTIVE
  To compare the management of fetal risk of isotretinoin in three countries, including information given to women, implementation of contraceptive methods, and pregnancy outcomes.
  
  
  METHODS
  Pregnant women exposed to isotretinoin who called teratogen information services (TIS) in Israel, Italy and Canada between July 1998 and October 2006 were interviewed at the time of initial consultation and after the expected day of delivery.
  
  
  RESULTS
  Fifty-three pregnant women exposed to isotretinoin contacted the TIS. Only 41% reported using a birth control method. Just one patient reported using two different forms. Forty-five percent of exposed pregnancies were terminated before delivery and 22% delivered healthy babies. Two babies were born with malformations.
  
  
  CONCLUSIONS
  Since isotretinoin-exposed pregnancies still occur, there is a need for more effective strategies, which should take into account the cultural differences.
authors: Division of Clinical Pharmacology & Toxicology, Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors: Facundo
authors: F
authors: Garcia-Bournissen
authors: Lilach
authors: L
authors: Tsur
authors: Lee H
authors: LH
authors: Goldstein
authors: Arthur
authors: A
authors: Staroselsky
authors: Marina
authors: M
authors: Avner
authors: Farhan
authors: F
authors: Asrar
authors: Matitiahu
authors: M
authors: Berkovitch
authors: Gianluca
authors: G
authors: Straface
authors: Gideon
authors: G
authors: Koren
authors: Marco
authors: M
authors: De Santis
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology* / Q000517:prevention & control; D000032:Abortion, Therapeutic; D000328:Adult; D002170:Canada; D003267:Contraception; D003879:Dermatologic Agents / Q000633:toxicity*; D004346:Drug Information Services; D005260:Female; D005333:Fetus / Q000187:drug effects*; D005500:Follow-Up Studies; D014943:Global Health; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D015474:Isotretinoin / Q000633:toxicity*; D007557:Israel; D007558:Italy; D050498:Live Birth; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011795:Surveys and Questionnaires; D013723:Teratogens
chemical_list: D003879:Dermatologic Agents; D013723:Teratogens; D015474:Isotretinoin