title: [Congenital Intermittent Third-degree Atrioventricular Block Associated with Retinoid Exposure in Pregnancy].
abstract: BACKGROUND
  The retinoid acitretin, which has been approved as an effective therapy for severe keratinization disorders, is highly teratogenic, and exposure in the first trimester of pregnancy is associated with the risk of miscarriage and various malformations, including congenital heart defects. Cardiac conduction system disorders have not been described so far.
  
  
  METHODS
  A 24-year-old woman was treated with acitretin for dyskeratosis follicularis until pregnancy was diagnosed at 12 weeks of gestation. The female infant was born after 35 weeks gestation by cesarean section because of intermittent fetal bradycardia. The baby was vigorous at birth (Apgar 9, 10, 10 at 1, 5 and 10 min) but displayed intermittent third-degree atrioventricular block. A search for maternal autoantibodies and viral infections gave negative findings.
  
  
  CONCLUSIONS
  The spectrum of disorders caused by intrauterine retinoid exposure appears to include atrioventricular conduction failure.
authors.affiliation: Neonatologie und Päd. Intensivmedizin, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln.
authors.forename: S
authors.initials: S
authors.lastname: Nijhof
authors.affiliation: Neonatologie und Päd. Intensivmedizin, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln.
authors.forename: P I
authors.initials: PI
authors.lastname: Kutz
authors.affiliation: St. Vincenz-Krankenhaus, Klinik für Frauenheilkunde und Geburtshilfe, Datteln.
authors.forename: R
authors.initials: R
authors.lastname: Schulze
authors.affiliation: Charité-Universitätsmedizin Berlin, Pharmakovigilanzzentrum Embryonaltoxikologie, Berlin.
authors.forename: C
authors.initials: C
authors.lastname: Schaefer
authors.affiliation: Kinderkardiologie, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln.
authors.forename: T
authors.initials: T
authors.lastname: Menke
authors.affiliation: Neonatologie und Päd. Intensivmedizin, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln.
authors.forename: C
authors.initials: C
authors.lastname: Roll
mesh_terms: D000328:Adult; D054537:Atrioventricular Block / Q000139:chemically induced* / Q000151:congenital* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000139:chemically induced / Q000175:diagnosis; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000175:diagnosis*; D012176:Retinoids / Q000009:adverse effects*
chemical_list: D012176:Retinoids