title: Association of high-dose bifonazole administration during early pregnancy and severe limb reduction defects in the newborn.
abstract: BACKGROUND
  Neonatal limb reduction defects may be caused by exposure to an external agent. The azole derivatives are used in the treatment of systemic and dermal mycoses. Their relative teratogenic risk is still controversial.
  
  
  METHODS
  We describe two newborns with severe limb defects who were exposed to high doses of oral (an unacceptable route) and/or intravaginal bifonazole during the entire first trimester of pregnancy.
  
  
  CONCLUSIONS
  Although only two cases are insufficient to establish a relationship, our data suggest that maternal intake of bifonazole in early pregnancy poses a risk of morphogenic malformations. The literature suggests several possible mechanisms.
authors.affiliation: Department of Neonatology, Rabin Medical Center, Petach Tikva, Israel. linderm@ netvision.net.il
authors.forename: Nehama
authors.initials: N
authors.lastname: Linder
authors.forename: Mandola
authors.initials: M
authors.lastname: Amarilla
authors.forename: Adriana
authors.initials: A
authors.lastname: Hernandez
authors.forename: Tsippy
authors.initials: T
authors.lastname: Tamiri
authors.forename: Lea
authors.initials: L
authors.lastname: Sirota
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levy
authors.forename: Paul
authors.initials: P
authors.lastname: Merlob
mesh_terms: D000014:Abnormalities, Drug-Induced; D000015:Abnormalities, Multiple / Q000209:etiology* / Q000473:pathology; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D007231:Infant, Newborn; D017880:Limb Deformities, Congenital / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents; D007093:Imidazoles; C036596:bifonazole