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Mycophenolate Mofetil in Pregnancy After Renal Transplantation: A Case of Major Fetal Malformations

Camille Le Ray, MD^*, Aurore Coulomb, MD^*, Elisabeth Elefant, MD, Rene Frydman, MD^* and François Audibert, MD^*

*Department of Obstetrics and Gynecology and Department of Pathology, Hôpital Antoine Béclère, Clamart, France; and Centre de Renseignements sur les Agents Tératogènes, Hôpital Armand Trousseau, Paris, France

Address reprint requests to: Pr. R. Frydman, Hôpital Antoine Béclère, 157, rue de la porte de Trivaux, 92140 Clamart, France; e-mail: florence.bequet{at}abc.ap-hop-paris.fr.

BACKGROUND: Mycophenolate mofetil has teratogenic properties in rats and rabbits. Previous human studies have reported an increased rate of fetal losses with its use. We report a case of major fetal malformations due to mycophenolate mofetil.

CASE: The patient was treated with mycophenolate mofetil before conception and during the first trimester of pregnancy. The fetus had multiple malformations, specifically, facial dysmorphology and midline anomalies, including agenesis of the corpus callosum.

CONCLUSION: This case of fetal malformation attributable to mycophenolate mofetil must be taken into consideration when considering pregnancy in an organ-transplant recipient.

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