Fetal warfarin syndrome

Fetal warfarin syndrome (FWS) is a rare condition which can occur as a result of fetal exposure to maternal ingestion of warfarin during pregnancy.

Clinical presentation

Reported clinical features include:

• facial anomalies
  • nasal bone hypoplasia
  • nasal bridge depression
• skeletal anomalies
  • stippled non-calcified epiphyses
  • shortened fingers: brachydactyly
  • nail hypoplasia
  • scoliosis
• central nervous system
  • intellectual disability
  • seizures
  • ventriculomegaly
  • agenesis of corpus callosum
  • microcephaly
  • microphthalmia
  • congenital cataracts
• cardiovascular
  • congenital cardiac anomalies

Pathology

Warfarin is a teratogenic drug. The increased risk of birth defects occurs particularly with warfarin use during ~6-9 weeks gestation.

Differential diagnosis

• some features (particularly skeletal) can mimic that of chondrodysplasia punctata