VACTERL ASSCIATION: IMPACT OF HERBAL AND OTHER ABORTIFACIENTS

*Azikiwe Cca and Ifezulike Cc

ABSTRACT

Background: Misoprostol is a prostaglandin analogue used to ripen the cervix, an anti peptic ulcer disease, oxytocics and as an abortifacient. Momordica foetida is a tropical flowering plant used in folkore for treatment of stomach upsets and aid in labour during childbirth. Case Report: We report a case of a 17year old social mother who worked as a food vendor. She took repeated doses of cytotec (Misoprostol) and aqueous extract of the freshly shoot and seeds of Momordica foetida in order to abort her unwanted pregnancy. All attempts up to 25weeks of gestation however failed to terminate her pregnancy. She though experienced intermittent blood spotting and very occasional frank bleeding between 7and 20 weeks of her gestation, there was no expulsion of the foetus. She came into spontaneous labour at 39 weeks 3days but, had an obstruction necessitating her referral for a caesarean section at our facility. Anaesthesia was regional spinal and baby was delivered within a few minutes. The baby however gave a single shrill cry with the only present left eye wide open and passed on. Further examination revealed a hydroencephalous with an amorphous indentation, deformed ear lobes, club feet, absence of anal perforation, pigeon chest and polydactyl. Conclusion: We conclude that repeated doses of misoprostol and Momortica foetida by the young mother led to the VACTERL association of the child. There is a potential and dangerous teratogenic synergism between herbal and orthodox abortifacients. Timely public enlightenment is highly advised. We recommend further full researches on Momordica foetida and its synergism with misoprostol or other prostaglandin agonist or analogue.

Keywords: Vacterl association, Abortion/miscarriage, Misoprostol, Momordica foetida, Multiple birth deformities, Teratogenic toxicity.