Denouement and Discussion
Aminopterin Embryopathy Syndrome
Aminopterin, a folic acid antagonist, has been used to induce abortions during the first trimester of pregnancy. Fetuses who survive this means of attempted abortion have a consistent pattern of malformations. These include prenatal and postnatal growth deficiency, lack of ossification of various cranial bones, delayed fontanel closure, lambdoid and coronal suture synostosis, upswept frontal hair pattern, broad nasal bridge, ocular hypertelorism, shallow supraorbital ridges, prominent eyes, micrognathia, cleft palate, and low-set posteriorly rotated ears. Skeletal defects consist of short forearms, hand abnormalities, congenital hip dislocation, and talipes equinovarus. Occasionally, cardiac and renal abnormalities occur. Intellectual function usually ranges from normal to mild retardation.
The various birth defects should be surgically repaired whenever possible. Special schooling is frequently helpful.