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Article
July 28, 1956

CONGENITAL ANOMALIES DUE TO ATTEMPTED ABORTION WITH 4-AMINOPTEROGLUTAMIC ACID

JAMA. 1956;161(13):1253. doi:10.1001/jama.1956.62970130002010a
Abstract

Thiersch1 used 4-aminopteroglutamic acid (Aminopterin), a folic acid antagonist, as an abortifacient in 12 patients for whom therapeutic abortion was indicated. The drug was given orally during the first trimester of pregnancy. An initial dose of 2 to 3 mg. was followed by 3 to 10 subsequent doses of 1 to 2 mg. at 12-hour intervals, some patients receiving as much as 20 mg. Fetal death and spontaneous abortion occurred in 10 of these patients; in the other 2 surgical evacuation became necessary, and in both live, malformed fetuses were detected, with deformities such as hydrocephalus, harelip, and cleft palate. In one of the 10 in whom abortion was delayed but finally occurred, a meningoencephalocele was detected. Thiersch suggested that, because fetal malformations occurred when early spontaneous abortion failed to take place after administration of 4-aminopteroglutamic acid, subsequent surgical evacuation of the pregnant uterus might be necessary to prevent

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