Prenatal diagnosis of methotrexate embryopathy

Obstet Gynecol. 2003 May;101(5 Pt 2):1104-7. doi: 10.1016/s0029-7844(03)00120-0.


Background: Methotrexate is an antineoplastic agent used by obstetrician-gynecologists for termination of early pregnancy. The drug is not always successful and is associated with a known array of malformations.

Case: We present a case of a failed pregnancy termination with methotrexate, which resulted in fetal anomalies. Ultrasound revealed absent or markedly shortened long bones, abnormal positioning of the hands, micrognathia, echogenic bowel, and a two-vessel umbilical cord. The patient elected to undergo pregnancy termination, and the ultrasound findings were confirmed at autopsy.

Conclusion: Because of methotrexate's teratogenic potential, follow-up to confirm successful termination is necessary. Ultrasound evaluation of the fetus is indicated if pregnancy termination is unsuccessful.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Drug-Induced / diagnostic imaging*
  • Abnormalities, Drug-Induced / etiology*
  • Abortifacient Agents, Nonsteroidal / adverse effects*
  • Abortion, Induced
  • Adult
  • Female
  • Humans
  • Methotrexate / adverse effects*
  • Pregnancy
  • Treatment Failure
  • Ultrasonography, Prenatal*


  • Abortifacient Agents, Nonsteroidal
  • Methotrexate