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Archivos argentinos de pediatría

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BARBERO, Pablo; LIASCOVICH, Rosa; VALDEZ, Rita  and  MORESCO, Angélica. Misoprostol teratogenicity: a prospective study in Argentina. Arch. argent. pediatr. [online]. 2011, vol.109, n.3, pp.226-231. ISSN 0325-0075.

Introduction. Misoprostol is commonly used in Argentina to attempt abortion, although a certain proportion of pregnancies is not interrupted. On the other hand, various reports showed an association between misoprostol and congenital anomalies. Objectives. To estimate the risk of major congenital anomalies in children prenatally exposed to misoprostol, and to know their way of consumption during pregnancy. Method. A cohort study compared the frequency of abortion and major congenital abnormalities in offspring of pregnant women exposed to misoprostol (94) and an unexposed group of pregnant women (401), both groups consulting to a teratology information service. Results. Among women exposed to misopro-stol only the 8.2% purchased it on prescription, 81.5% heard about its abortifacient effect by friends, neighbors or relatives, the average dose was 1.439 mg which was used both orally and vaginally by the 77.2%; the mean gestational age was 48.5 days and 35.2% used an additional abortive agent. Women exposed to misoprostol had a significantly higher frequency of abortions (exposed: 17/94= 18.1%, unexposed, 29/401= 7.2%, RR= 2.27, 95%: 1,30-3,98), and offspring with major congenital abnormalities (exposed: 5/77= 6.49%, unexposed: 8/372= 2.15%, RR= 3.02, 95%:1,02-8.98). The five malformed children prenatally exposed to misoprostol showed: 1) encephalocele and transverse limb defects; 2) porencephaly, 3) pulmonary adenomatous cystic malformation, 4) occipital encephalocele and, 5) intestinal malrotation. Conclusions. The study found a significant association between prenatal exposure to misoprostol and the occurrence of major congenital anomalies.

Keywords : Congenital anomalies; Teratogenic agents; Misoprostol; Abortion.

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