<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412023000200140</article-id>
<article-id pub-id-type="doi">10.24245/gom.v91i2.7239</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Anomalías congénitas disruptivas asociadas con misoprostol. Reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Disruptive congenital anomalies associated with misoprostol. Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villagómez-Mendoza]]></surname>
<given-names><![CDATA[Edgar Allan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acevedo-Gallegos]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallardo-Gaona]]></surname>
<given-names><![CDATA[Juan Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Velázquez-Torres]]></surname>
<given-names><![CDATA[Berenice]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Calvo]]></surname>
<given-names><![CDATA[José Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguinaga-Ríos]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Perinatología Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Perinatología Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Perinatología Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Nacional de Perinatología Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>91</volume>
<numero>2</numero>
<fpage>140</fpage>
<lpage>146</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412023000200140&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412023000200140&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412023000200140&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES: La exposición prenatal al misoprostol puede asociarse con un espectro de defectos congénitos que varían desde anomalías del sistema nervioso central, secuencia de Moebius, defectos en la pared abdominal, defectos transversales en las extremidades hasta alteraciones fetales. Esos defectos se observan más comúnmente con esquemas de solo misoprostol para inducción del aborto. Por esos antecedentes es importante que la historia clínica de toda paciente obstétrica sea exhaustiva para permitir identificar el antecedente de la exposición prenatal luego de un aborto fallido.  CASO CLINICO:  Paciente de 21 años, con 32 semanas de embarazo, con diagnóstico de feto con ventriculomegalia. En la evaluación ecográfica destacó la ventriculomegalia triventricular severa, simétrica y la angulación de ambas extremidades inferiores en varo. La resonancia magnética reportó: ventriculomegalia no comunicante severa, bilateral, simétrica, por probable estenosis del acueducto de Silvio. Cariotipo 46,XY y perfil TORCH negativo. El embarazo finalizó mediante cesárea, por indicación fetal a las 35 semanas. La evaluación al nacimiento reportó: parálisis facial bilateral, macrocefalia y pie equino varo bilateral. Al volver a interrogar a la paciente refirió haber sido tratada con misoprostol en el primer trimestre del embarazo, con fines abortivos. Al descartar las alteraciones cromosómicas e infecciosas se estableció el diagnóstico de secuencia Moebius.  CONCLUSIONES: La exposición prenatal al misoprostol está relacionada con la aparición de defectos vasculares en algunos fetos expuestos. Aún no se ha determinado el espectro preciso ni la estimación potencial de teratogenicidad. La historia clínica es el pilar para la asociación en estos casos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND: Prenatal misoprostol exposure can be associated with a spectrum of birth defects, ranging from central nervous system abnormalities, Moebius sequence, abdominal wall defects, as well as transverse limb defects, fetal abnormalities are more commonly seen with the use of the misoprostol-only regimen for induction of abortion, such that a thorough medical history is essential to detect a history of prenatal exposure after a failed abortion.  CLINICAL CASE:  A 21-year-old patient, with a 32-week pregnancy, who attended the institute with a diagnosis of a fetus with ventriculomegaly, the ultrasound evaluation highlighted severe symmetric triventricular ventriculomegaly and angulation of both lower extremities in varus, magnetic resonance imaging reported severe non-communicating ventriculomegaly Symmetric bilateral, due to probable stenosis of the aqueduct of Silvio, the karyotype reported 46, XY, as well as a negative TORCH profile, however, a cesarean section was performed for fetal indication at 35 weeks, the evaluation at birth showed bilateral facial paralysis, macrocephaly and foot Bilateral equinus varus, upon re-examination the patient referred the use of misoprostol in the first trimester of pregnancy for abortive purposes, so as there were no chromosomal or infectious alterations, a Moebius sequence was suggested.  CONCLUSIONS : Prenatal exposure to misoprostol is related to the appearance of vascular disruption defects in some exposed fetuses, the precise spectrum and potential estimation of teratogenicity have not yet been determined, the clinical history is the mainstay for the association in these cases.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndrome de Moebius]]></kwd>
<kwd lng="es"><![CDATA[exposición prenatal a misoprostol]]></kwd>
<kwd lng="es"><![CDATA[misoprostol en el primer trimestre]]></kwd>
<kwd lng="en"><![CDATA[Moebius syndrome]]></kwd>
<kwd lng="en"><![CDATA[Prenatal exposure to misoprostol]]></kwd>
<kwd lng="en"><![CDATA[Misoprostol in the first trimester]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez-Rodríguez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Malformaciones congénitas asociadas al uso de misoprostol: Reporte de dos casos]]></article-title>
<source><![CDATA[Rev Mex Neuroci]]></source>
<year>2013</year>
<volume>14</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>50-3</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pastuszak]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of misoprostol during pregnancy and Mobius syndrome in infants]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1998</year>
<volume>338</volume>
<numero>26</numero>
<issue>26</issue>
<page-range>1881-5</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tang]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Misoprostol: Pharmacokinetic profiles, effects on the uterus and side-effects]]></article-title>
<source><![CDATA[Int J Gynecol Obstet]]></source>
<year>2007</year>
<volume>99</volume>
<page-range>S160-7</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vargas]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prenatal exposure to misoprostol and vascular disruption defects: A Case-Control Study]]></article-title>
<source><![CDATA[Am J Med Genet]]></source>
<year>2000</year>
<volume>95</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>302-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gaglioti]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The significance of fetal ventriculomegaly: etiology, short and long term-outcomes]]></article-title>
<source><![CDATA[Prenat Diagn]]></source>
<year>2009</year>
<volume>29</volume>
<page-range>381-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gaglioti]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fetal cerebral ventriculomegaly: outcome in 176 cases]]></article-title>
<source><![CDATA[Ultrasound Obstet Gynecol]]></source>
<year>2005</year>
<volume>25</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>372-7</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boss-Thompson]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Moebius syndrome in a neonate after Mifepristone and Misprostol elective abortion failure]]></article-title>
<source><![CDATA[Annals of Pharmacotherapy]]></source>
<year>2008</year>
<volume>42</volume>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Breeze]]></surname>
<given-names><![CDATA[ACG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstetric and neonatal outcomes in apparently isolated mild fetal ventriculomegaly]]></article-title>
<source><![CDATA[J Perinat Med]]></source>
<year>2005</year>
<volume>33</volume>
<page-range>236-40</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vergani]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical outcome of mild fetal ventriculomegaly]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>1998</year>
<volume>178</volume>
<page-range>218-22</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Griffiths]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A prospective study of fetuses with isolated ventriculomegaly investigated by antenatal sonography and in utero MR imaging]]></article-title>
<source><![CDATA[AJNR Am J Neuroradiol]]></source>
<year>2010</year>
<volume>31</volume>
<page-range>106-11</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pagani]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurodevelopmental outcome in isolated mild fetal ventriculomegaly: systematic review and meta-analysis]]></article-title>
<source><![CDATA[Ultrasound Obstet Gynecol]]></source>
<year>2014</year>
<volume>44</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>254-60</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Achiron]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fetal mild idiopathic lateral ventriculomegaly: is there a correlation with fetal trisomy?]]></article-title>
<source><![CDATA[Ultrasound Obstet Gynecol]]></source>
<year>1993</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>89</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Norton]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Fetal cerebral ventriculomegaly]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<collab>Society for Maternal-Fetal Medicine (SMFM)</collab>
<article-title xml:lang=""><![CDATA[Mild fetal ventriculomegaly: diagnosis, evaluation, and management]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2018</year>
<volume>219</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>B2</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pisapia]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fetal ventriculomegaly: Diagnosis, treatment, and future directions]]></article-title>
<source><![CDATA[Childs Nerv Syst]]></source>
<year>2017</year>
<volume>33</volume>
<page-range>1113-23</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adam]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Pagon]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Wallace]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
</person-group>
<source><![CDATA[Gene Reviews]]></source>
<year></year>
<page-range>1993-2022</page-range><publisher-loc><![CDATA[Seattle ]]></publisher-loc>
<publisher-name><![CDATA[University of Washington]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tanchi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Carey-Fineman-Ziter syndrome: a spectrum of presentations]]></article-title>
<source><![CDATA[Case Rep Perinat Med]]></source>
<year>2012</year>
<volume>1</volume>
<numero>1-2</numero>
<issue>1-2</issue>
<page-range>99-102</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chicarilli]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Oromandibular Limb Hypogenesis Syndrome]]></article-title>
<source><![CDATA[Plastic and Reconstructive Surgery]]></source>
<year>1985</year>
<volume>76</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castelino]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Oromandibular-limb hypogenesis syndrome type II C: A rare case]]></article-title>
<source><![CDATA[J Dent Res Dent Clin Dent Prospects]]></source>
<year>2010</year>
<volume>4</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>136-9</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jabbour]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prostaglandin receptor signalling and function in human endometrial pathology]]></article-title>
<source><![CDATA[TRENDS in Endocrinology and Metabolism]]></source>
<year>2004</year>
<volume>15</volume>
<numero>8</numero>
<issue>8</issue>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bell]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Will the real Moebius syndrome please stand up? A systematic review of the literature and statistical cluster analysis of clinical features]]></article-title>
<source><![CDATA[Am J Med Genet.]]></source>
<year>2019</year>
<volume>179A</volume>
<page-range>257-65</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Slee]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Deletion of chromosome 13 in Moebius syndrome]]></article-title>
<source><![CDATA[J Med Genet]]></source>
<year>1991</year>
<volume>28</volume>
<page-range>413-4</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matsui]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical Characteristics and outcomes of Mo&#776;bius Syndrome in a Children&#8217;s Hospital]]></article-title>
<source><![CDATA[Pediatric Neurology]]></source>
<year>2014</year>
<volume>51</volume>
<page-range>781e789</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gonzalez]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Limb deficiency with or without Möbius sequence in seven Brazilian children associated with misoprostol use in the first trimester of pregnancy]]></article-title>
<source><![CDATA[Am J Med Genet]]></source>
<year>1993</year>
<volume>47</volume>
<page-range>59-64</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silva Dal Pizzol]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prenatal exposure to misoprostol and congenital anomalies: Systematic review and meta-analysis]]></article-title>
<source><![CDATA[Reproductive Toxicology]]></source>
<year>2006</year>
<volume>22</volume>
<page-range>666-71</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
