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KMID : 0361720120230040292
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Korean Journal of perinatology
2012 Volume.23 No. 4 p.292 ~ p.297
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Persistent Pulmonary Hypertension of the Newborn in a Preterm Infant Exposed to Methotrexate During the Early Gestational Period
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Suh Young-Eun
Lee Byung-Sop
Choi Yong-Sung
Kim Ai-Rhan
Kim Ki-Soo
Kim Jong-Jae
Won Hye-Sung
Lim Gi-Na
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Abstract
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Methotrexate (MTX) is used in the reproductive aged females for the management of medical conditions such as ectopic pregnancy, autoimmune diseases and malignancies. Because of its antimetabolite effect, exposure to MTX during the fetal period can cause multiple anomalies. The most common anomalies related to intrauterine MTX exposure include growth retardation, craniofacial dysmorphism, central nervous system anomalies, cardiac anomalies and skeletal defects. We report a premature baby boy born after 27+5 weeks of gestation who presented intrauterine growth restriction, single umbilical artery, small chest and anomalies of rib and thoracic vertebra. His mother had received 50 mg of MTX for the treatment of misdiagnosed ectopic pregnancy at 5th week of gestation. During the hospitalization, he was ventilator dependent and pulmonary hypertension persisted despite medical treatment including nitric oxide and sildenafil. Open lung biopsy revealed nonspecific findings suggestive of lung hypoplasia. He died at 141 days after birth due to respiratory failure.
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KEYWORD
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Methotrexate, Congenital anomalies, Pulmonary hypoplasia, Persistent pulmonary hypertension of the newborn
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