High-yield teratogenic patterns.
| Drug | Effect |
|---|---|
| ACE inhibitors / ARBs | Renal agenesis → Potter sequence, oligohydramnios |
| Warfarin | Nasal hypoplasia + stippled epiphyses (fetal warfarin syndrome) |
| Isotretinoin (vit A) | Severe craniofacial + CNS + cardiac (use iPLEDGE) |
| Methotrexate | Aminopterin syndrome — limb + craniofacial defects |
| Lithium | Ebstein anomaly (tricuspid valve) |
| Methimazole (1st trim) | Cutis aplasia (absence of skin); choanal/esophageal atresia |
| Phenytoin | Fetal hydantoin syndrome (cleft lip/palate, cardiac defects) |
| Valproate | Neural tube defects (highest risk anticonvulsant) |
| Carbamazepine | Neural tube defects + craniofacial |
| Tetracyclines | Tooth discoloration + bone growth inhibition |
| Fluoroquinolones | Cartilage damage |
| Aminoglycosides | Ototoxicity (CN VIII) |
| NSAIDs (3rd trim) | Premature ductus arteriosus closure + oligohydramnios |
| Thalidomide | Phocomelia (limb defects) |
| DES (historical) | Clear cell adenocarcinoma of vagina in daughters |
| Alcohol | Fetal alcohol syndrome (FAS) — facial dysmorphism, growth restriction, neuro |
| Cocaine | Placental abruption, IUGR, neonatal stroke |
| Tobacco | IUGR, preterm birth, placental abruption |
Test yourself before moving on. ~1 min.