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What Is the Chance of a Normal Pregnancy in a Woman Whose Fetus Has Been Exposed to Isotretinoin?
Michael J. Sladden, MAE, MRCP(UK);
Karen E. Harman, MD, MRCP
Arch Dermatol. 2007;143(9):1187-1188.
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Clinical Question
Recently, one of our patients who was taking isotretinoin became pregnant. This occurred despite appropriate counseling, a negative pregnancy test result before commencing treatment, and use of the combined oral contraceptive pill Microgynon 30 (Schering Health Care, West Sussex, England) (levonorgestrel, 150 µg, ethinylestradiol, 30 µg). The patient did not want to terminate her pregnancy. The aim of this Critically Appraised Topic is to explore the literature to determine the chance of delivering a healthy child after fetal exposure to isotretinoin; the types of fetal malformations associated with it; and what monitoring should be performed.
Background
Since introduction of the drug in 1982, over 2000 pregnancies in the United States have been affected by fetal exposure to isotretinoin,1 most resulting in spontaneous or elective abortions.2-6
Literature Search
We searched the Medline and EmBase databases from 1966 to March 2007 using the terms isotretinoin . . . [Full Text of this Article]
Appraisal of the Evidence
Limitations
Clinical Bottom Line
What Happened to Our Patient?
AUTHOR INFORMATION
Department of Medicine, University of Tasmania, Launceston, Australia (Dr Sladden), and Department of Dermatology, Leicester Royal Infirmary, Leicester, England (Dr Harman)
RELATED ARTICLE
Accessible Evidence-Based Medicine: Critically Appraised Topics
David A. Barzilai and Martin A. Weinstock
Arch Dermatol. 2007;143(9):1189-1190.
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