Risk of drug-induced congenital defects.

Defects attributable to drug therapy represent about 1% of congenital defects of known aetiology. This means that a precautionary attitude and correct use of drugs in fertile, and especially pregnant, women is a feasible form of prevention. Drugs currently in use with proven teratogenic effect number approximately 25, but new pharmaceutical drugs are constantly in preparation. Recognition of a drug-induced teratogenic effect is a complex procedure taking into account not only experimental animal data but also experience in humans. Considering that 40% of pregnancies are not planned, it follows that any drug with known or suspected teratogenic potential must be used only under strict medical control. Also, adequate knowledge on potential teratogenicity of a drug permits modification of therapy before conception. It goes without saying that any drug should be used during pregnancy only if it is essential, and it would be prudent to use only those where adequate information is provided and prior clinical experience is available. Teratology Information Services can assist both physicians and patients when any doubt exists.

First case of post-conception Verteporfin exposure: pregnancy and neonatal outcome.

PURPOSE: To assess pregnancy and neonatal outcomes in a woman accidentally exposed to Verteporfin photodynamic therapy in the third week of pregnancy. METHODS: Post-conception counselling and prospective follow-up by telephone interview at Telefono Rosso (Teratology Information Service) were carried out. The baby was examined at birth and at 26 months. RESULTS: The outcome of the pregnancy was normal and a healthy female child with a normal birthweight was born. The baby's follow-up was normal at 26 months. CONCLUSIONS: This is the first reported case of a childbearing woman being accidentally exposed to Verteporfin during pregnancy. No fetal or neonatal adverse effects were documented.

Latanoprost exposure in pregnancy.

PURPOSE: To observe pregnancies exposed to latanoprost, a prostaglandin analog administered in the treatment of glaucoma. Its prescription is limited in pregnancy, because reproduction studies in animals report a high incidence of abortion and human investigations are not adequate. As a consequence it is classified as category C drug according to the United States Food and Drug Administration's use-in-pregnancy ratings. DESIGN: Observational study. METHODS: We collected data, referred to our Teratology Information Service, relative to latanoprost exposure in pregnancy. We followed by phone interviews women treated with latanoprost during the first trimester, and we evaluated whether there had been any adverse effects on the fetus. RESULTS: Eleven cases of latanoprost exposure in pregnancy were referred to our Teratology Information Service. One case was lost to follow-up, and one case was complicated by miscarriage. Nine cases had a complete follow-up without congenital anomalies. CONCLUSIONS: Our series is too small to perform statistical significance; however, we found no evidence of adverse effects of latanoprost on pregnancy or neonatal outcomes.

Maternal mortality in Italy, 1980-1996.

OBJECTIVE: To establish the extent of maternal mortality in Italy in between 1980 and 1996 in order to compare it with the international data. STUDY DESIGN: We conducted a retrospective study on maternal deaths in Italy from 1980 to 1996. Data have been collected by Italian Statistic Institute (ISTAT). We calculated both the maternal mortality rates and the percentages of causes of death in the whole period, according to WHO definitions. RESULTS: The data confirmed the trends of the previous decade: maternal mortality rates have decreased from 13.25 (1980) to 3.78 (1996) for 100000 live births. Haemorrhage and hypertension have been the main causes of maternal death, while pulmonary embolism has had a minor affect on maternal mortality rates compared to other countries, particularly in Europe. CONCLUSION: Italian data appear reassuring and encourage further investigations on detailed welfare problems.

Paternal exposure to ribavirin: pregnancy and neonatal outcome.

We report seven cases of newborns conceived within 6 months from the end or during paternal ribavirin exposure.