title: Exposure to methylergonovine maleate as a cause of sirenomelia.
abstract: BACKGROUND
  Sirenomelia is a rare, but deadly condition characterized by fusion of the lower limbs, lower spinal column defects, severe malformations of the urogenital and lower gastrointestinal tract, and an aberrant abdominal umbilical artery.
  
  
  METHODS
  The two main hypotheses, not mutually exclusive, that have been advanced to explain the pathogenesis of sirenomelia are the blastogenetic theory and the vascular disruption theory.
  
  
  RESULTS
  We describe a case of sirenomelia, probably associated with the use of methylergonovine maleate, an ergot alkaloid, during the first weeks of pregnancy.
  
  
  CONCLUSIONS
  On the basis of the mechanisms of vascular disruption and early administration of methylergonovine maleate at a critical stage of organogenesis, we conclude that exposure to methylergonovine maleate could be the cause of the development of sirenomelia. Birth Defects Research (Part A) 106:643-647, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Careggi University Hospital, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Cozzolino
authors.affiliation: Private Practice, Futura Diagnostica Medica, Firenze, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Riviello
authors.affiliation: Service of Pathology, Hospital of Bolzano, Bolzano, Italy.
authors.forename: Gertrud
authors.initials: G
authors.lastname: Fichtel
authors.affiliation: Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Careggi University Hospital, Florence, Italy.
authors.forename: Mariarosaria Di
authors.initials: MD
authors.lastname: Tommaso
mesh_terms: D000328:Adult; D004480:Ectromelia / Q000139:chemically induced / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D008755:Methylergonovine / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy
chemical_list: D008755:Methylergonovine
keywords: malformation; methylergonovine maleate; pregnancy; sirenomelia; teratology