A Warfarin Embryopathy?

A remarkable syndrome of congenital anomalies has been described in recent years, which has been tentatively attributed to maternal consumption of warfarin sodium (Coumadin) throughout pregnancy. One case reported by Kerber et al¹in 1968 described pregnancy in a patient with a prosthetic valve, associated with a fetal anomaly ascribed by the authors to warfarin administration. Before this publication, DiSaia,²in 1966, recorded the pregnancy of a woman with a Starr-Edwards mitral valve prosthesis, resulting in the birth of a baby with hypoplasia of nasal structures, bilateral optic atrophy, blindness, and mental retardation. Warfarin was among the drugs taken by the mother during the first trimester, but the author found it difficult to relate the congenital defects of the child to the maternal drug consumption. The same infant was mentioned and illustrated by Holmes et al³who considered the child's condition as a warfarin embryopathy. By the