Carbimazole is associated with all except :
Cleft lip and palate Congenital malformations associated with carbimazole Scalp or patchy hair defect (aplasia cutis congenita) Choanal atresia Sacral pilonidal sinus Tracheoesophageal fistula Fetal goitre Hypoplastic or absent phalanges (low set fifth finger) Psychomotor delay Minor facial anomaly (Flat face, low set ears, upper lipetraction) Pregnancy and thyroid disease Thyrotoxicosis occurs in about 2% of pregnancies and is caused most frequently by Grave's disease. Antithyroid drugs are the t/t of choice ; radioactive iodine is clearly contraindicated in pregnancy. Historically, propylthiouracil has been preferred over methimazole because transplacental spread was though to be lower, however, it has been proved that propylthiouracial and methimazole cross the placenta equally. As clearance of these drugs is very slow in the fetus, they tend to accumulate with the risk of fetal hypothyroidism and goitrogenesis. Current datas suggest that either may be used safely in the pregnant patients. The antithyroid drug dose should be minimal in order to keep the serum free thyroxine index in the upper half of the normal range. As pregnancy progresses, graves disease often improves and it is not uncommon for patients either to be on very low doses or off antithyroid drugs completely by the end of pregnancy. Propylthiouracil is the drug of choice in nursing women since very small amounts of the drug appear in the breast milk, and do not appear to affect thyroid function in the suckling baby. Common tetratogenic drugs Isotretinoin Craniofacial abnormality - Cleft lip and palate - Microcephaly Cardiovascular anomaly - ASD C.N.S. anomaly - Neural tube defect - Microcephaly Lithium Ebstein anomaly Fetal goitre Alcohol Fetal alcohol syndrome Fetal micmcephaly Maxillary hypoplasia Mental retardation Cardiac (ASD, PDA) Hype rkinetic child Growth retardation Small eve Methanol Craniofacial abnormality - Microcephaly - Maxillary hypoplasia Mental retardation/growth retardation Phenytoin Fetal hydantoin syndrome Microcephaly Cleft lip and palate Hypoplastic phalanges Gum hyperplasia Warfarin Contradil syndrome - Croniofacial abnormality - Chondrodysplasia punctata Barbiturates Congenital hea disease Cleft lip and palate Neonatal dependence Respiratory depression Stilbesterol Vagina[ carcinoma Tetracycline Discoloured teeth Bone growth retardation Thalidomide Phocornelia Valproate Neural tube defects Indomethacin Premature closure of ductus aeriosus
>Choanal atresia
>Cleft lip and cleft palate
>Scalp defect
>Neck swelling