A 29-year-old woman with a mechanical mitral valve prosthesis becomes pregnant while taking an oral anticoagulant. Her obstetrician warns that continued use during the first trimester causes fetal nasal hypoplasia and stippled epiphyses. On examination, BP is 118/76 mmHg, HR 82/min, and she denies vaginal bleeding. Prothrombin time is elevated at 2.8 INR. Which medication is responsible for these characteristic teratogenic effects?
- A)Aspirin
- B)Apixaban
- C)WarfarinGABARITO
- D)Heparin
- E)Clopidogrel
Explicação
Warfarin is teratogenic and classically causes fetal bleeding, nasal hypoplasia, and stippled epiphyses. It inhibits vitamin K epoxide reductase, reducing gamma carboxylation of clotting factors II, VII, IX, X and proteins C and S. Ver explicação completa e trilha adaptativa →