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Warfarin (Coumadin) Embryopathy
Janice L. B. Byrne, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Fetal warfarin (Coumadin) syndrome
            • Definitions

              • Fetal effects of early gestational exposure to warfarin, vitamin K antagonist
              • Phenocopy of chondrodysplasia punctata

            IMAGING

            • General Features

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            Selected References

                            1. Chetot T et al: Vitamin K antagonist rodenticides display different teratogenic activity. Reprod Toxicol. 93:131-6, 2020
                            2. R Sousa A et al: Low-dose warfarin maternal anticoagulation and fetal warfarin syndrome. BMJ Case Rep., 2018
                            3. Cassina M et al: Human teratogens and genetic phenocopies. Understanding pathogenesis through human genes mutation. Eur J Med Genet. 60(1):22-31, 2017
                            4. Hüttel E et al: Pregnancy outcome of first trimester exposure to the vitamin K antagonist phenprocoumon depends on duration of treatment. Thromb Haemost. 117(5):870-9, 2017
                            5. Songmen S et al: Chondrodysplasia punctata: a case report of fetal warfarin syndrome. J Nepal Health Res Counc. 15(1):81-4, 2017
                            6. Basu S et al: Low-dose maternal warfarin intake resulting in fetal warfarin syndrome: in search for a safe anticoagulant regimen during pregnancy. Birth Defects Res A Clin Mol Teratol. 106(2):142-7, 2015
                            7. Silveira DB et al: Importance of a multidisciplinary approach and monitoring in fetal warfarin syndrome. Am J Med Genet A. 167(6):1294-9, 2015
                            8. McLintock C: Anticoagulant choices in pregnant women with mechanical heart valves: balancing maternal and fetal risks--the difference the dose makes. Thromb Res. 131 Suppl 1:S8-10, 2013
                            9. Starling LD et al: Fetal warfarin syndrome. BMJ Case Rep. 2012, 2012
                            10. Keppler-Noreuil KM et al: Binder phenotype: associated findings and etiologic mechanisms. J Craniofac Surg. 21(5):1339-45, 2010
                            11. Howe AM et al: The growth of the nasal septum in the 6-9 week period of foetal development--Warfarin embryopathy offers a new insight into prenatal facial development. Aust Dent J. 49(4):171-6, 2004
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Pathology

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Synonyms

                                        • Fetal warfarin (Coumadin) syndrome
                                      • Definitions

                                        • Fetal effects of early gestational exposure to warfarin, vitamin K antagonist
                                        • Phenocopy of chondrodysplasia punctata

                                      IMAGING

                                      • General Features

                                        • Imaging Recommendations

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      Selected References

                                                      1. Chetot T et al: Vitamin K antagonist rodenticides display different teratogenic activity. Reprod Toxicol. 93:131-6, 2020
                                                      2. R Sousa A et al: Low-dose warfarin maternal anticoagulation and fetal warfarin syndrome. BMJ Case Rep., 2018
                                                      3. Cassina M et al: Human teratogens and genetic phenocopies. Understanding pathogenesis through human genes mutation. Eur J Med Genet. 60(1):22-31, 2017
                                                      4. Hüttel E et al: Pregnancy outcome of first trimester exposure to the vitamin K antagonist phenprocoumon depends on duration of treatment. Thromb Haemost. 117(5):870-9, 2017
                                                      5. Songmen S et al: Chondrodysplasia punctata: a case report of fetal warfarin syndrome. J Nepal Health Res Counc. 15(1):81-4, 2017
                                                      6. Basu S et al: Low-dose maternal warfarin intake resulting in fetal warfarin syndrome: in search for a safe anticoagulant regimen during pregnancy. Birth Defects Res A Clin Mol Teratol. 106(2):142-7, 2015
                                                      7. Silveira DB et al: Importance of a multidisciplinary approach and monitoring in fetal warfarin syndrome. Am J Med Genet A. 167(6):1294-9, 2015
                                                      8. McLintock C: Anticoagulant choices in pregnant women with mechanical heart valves: balancing maternal and fetal risks--the difference the dose makes. Thromb Res. 131 Suppl 1:S8-10, 2013
                                                      9. Starling LD et al: Fetal warfarin syndrome. BMJ Case Rep. 2012, 2012
                                                      10. Keppler-Noreuil KM et al: Binder phenotype: associated findings and etiologic mechanisms. J Craniofac Surg. 21(5):1339-45, 2010
                                                      11. Howe AM et al: The growth of the nasal septum in the 6-9 week period of foetal development--Warfarin embryopathy offers a new insight into prenatal facial development. Aust Dent J. 49(4):171-6, 2004