Maternal Use of Cytostatic/Cytotoxic Drugs or Endocrine Drugs for Malignancy and Infant Congenital Malformations
For most cytotoxic drugs, when used during the first trimester for maternal malignancy, a substantial risk for teratogenesis may exist and such use should be avoided. If inadvertent exposure occurs, one has to calculate with a fetal risk and the possibility of induced abortion (when available) should be discussed. When used as immune suppressants at other diseases (e.g., rheumatoid arthritis or immunological bowel disease), lower doses are usually used and the risk for teratogenesis seems reduced even for a known teratogen like methotrexate. Exposures for these drugs are relatively rare but in the individual case a careful consideration of the risk is needed. Unfortunately information for individual drugs or combinations of drugs is often incomplete.
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