Omphalocele in fetus at 13 weeks' gestation exposed to sodium valproate in utero

Yıl 2009, Cilt: 40 Sayı: 2, 79 - 82, 01.03.2009

Aysun Aybatlı Petek Balkanlı Kaplan

Öz

Omphalocele occurs in 1/3200 to 1/10 000 livebirths. It is a defect in the anterior abdominal wall with extrusion of abdominal contents into the base of the umblical cord. In nearly 50 % of cases, the omphalocele is associated with other malformations. Also it may be a manifestation of multiple anomaly syndromes including Beckwith-Wiedemann and CHARGE, trisomies 13, 18, 21 and triploidy. Valproic acid and valproic acid sodium are anticonvulsive drugs used in the treatment of epileptic disorders. Drug passes fetus through plasenta rapidly. It causes major and minor congenital anomalies, intrauterine growth restriction, hyperbiluribunemia, hepatotoxicity, transient hyperglisinemia, fetal and neonatal distress when used in pregnancy. In the present article, a fetus with omphalocele diagnosed at 13 weeks gestation exposed to sodium valproate in utero are presented and the subject is discussed in the light of contemporary literature.

Anahtar Kelimeler

Valproic Acid, Hernia, Umbilical, Pregnancy Complications, Adverse effects, Abortion, Induced

İn utero sodyum valproata maruz kalan 13-14 haftalık. omfalosel olgusu

Öz

Omfalosel 1/3200 ile 1/10 000 canlı doğum arasında görülen nadir bir durumdur. Abdominal içeriğin orta hattan herniye olması olarak tanımlanabilir. Vakaların yaklaşık yarısı diğer malformasyonlarla ilişkilidir. Ayrıca multipl anomali sendromları (Beckwith-Wiedemann ve CHARGE gibi), trizomi 13, 18, 21 ve triploidiler de eşlik edebilmektedir. Valproik asid ve tuz formu sodyum valproate konvülsif hastalıkların tedavisinde kullanılan antikonvüzanlardır. İlaç, plasentadan fetüse hızla geçmektedir. Gebelikte valproik asid ve sodyum valproate kullanımında görülen fetal ve neonatal sorunlar arasında majör ve minör konjenital anomaliler, intrauterin gelişme geriliği, hiperbiluribinemi, hepatotoksisite, geçici hiperglisinemi, fetal ve neonatal distres sayılabilmektedir. Makalede, gebeliği esnasında valproik asid kullanan ve 13-14 hafialılf iken yapılan ultrasonografide omfalosel tespit edilen olgu sunularak, konu güncel literatürün ışığında tartışılmıştır.

Anahtar Kelimeler

Valproik asit, Fıtık, göbek, Gebelik komplikasyonları, Yan etkiler, Düşük, istemli

Kaynakça

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