Everolimus in pregnancy: Case report and literature review

J Obstet Gynaecol Res. 2017 Aug;43(8):1350-1352. doi: 10.1111/jog.13369. Epub 2017 May 29.

Abstract

There have been few reports on the effects of everolimus on the fetus, but none of six infants with documented everolimus exposure in utero had congenital malformations. A 32-year-old nulliparous woman on everolimus (5.0 mg/day) for renal angiomyolipoma (AML) due to tuberous sclerosis complex (TSC) was found to be pregnant at gestational week (GW) 7-5/7, at which time everolimus was withheld. To control AML in this patient, transarterial embolization was performed in the right and left kidneys at GW 21 and 24, respectively, and everolimus was reinitiated at GW 25. The patient gave birth at GW 37 to a normally formed infant weighing 3057 g, but who had cardiac tumors thought to be rhabdomyomas due to inherited TSC. Thus, although data are still limited, everolimus may be promising with respect to teratogenicity. Everolimus concentration in the maternal and umbilical cord blood at birth was 1.1 ng/mL and 1.0 ng/mL, respectively.

Keywords: angiomyolipoma; everolimus; malformation; teratogenicity; tuberous sclerosis complex.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Angiomyolipoma / drug therapy*
  • Angiomyolipoma / etiology
  • Antineoplastic Agents / therapeutic use*
  • Everolimus / therapeutic use*
  • Female
  • Humans
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / etiology
  • Pregnancy
  • Pregnancy Complications, Neoplastic / drug therapy*
  • Pregnancy Complications, Neoplastic / etiology
  • Tuberous Sclerosis / complications*

Substances

  • Antineoplastic Agents
  • Everolimus