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Edgardo Abalos - One of the best experts on this subject based on the ideXlab platform.
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conservative management of symptomatic and or complicated haemorrhoids in pregnancy and the puerperium
Cochrane Database of Systematic Reviews, 2005Co-Authors: Cesar Eugenio Quijano, Edgardo AbalosAbstract:BACKGROUND: Haemorrhoids (piles) are swollen veins at or near the anus, normally asymptomatic. They do not constitute a disease, unless they become symptomatic. Pregnancy and the puerperium predispose to symptomatic haemorrhoids, being the most common ano-rectal disease at these stages. Symptoms are usually mild and transient and include intermittent bleeding from the anus and pain. Depending on the degree of pain, quality of life could be affected, varying from mild discomfort to real difficulty in dealing with the activities of everyday life. Treatment during pregnancy is mainly directed to the relief of symptoms, especially pain control. The so-called conservative management includes dietary modifications, stimulants or depressants of the bowel transit, local treatment, and phlebotonics (drugs that cause decreased capillary fragility, improving the microcirculation in venous insufficiency). For many women, symptoms will resolve spontaneously soon after birth, and so any corrective treatment is usually deferred to some time after birth. Thus, the objective of this review is to evaluate the efficacy of conservative management of piles during pregnancy and the puerperium. OBJECTIVES: To determine the possible benefits, risks and side-effects of the conservative management of symptomatic haemorrhoids during pregnancy and the puerperium. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 June 2004). SELECTION CRITERIA: Randomised-controlled trials comparing any of the conservative treatments for symptomatic haemorrhoids during pregnancy and the puerperium (such as dietary modifications, stimulant/depressant of the bowel transit, local treatments, drugs that improve the microcirculation in venous insufficiency) with a placebo or no treatment. DATA COLLECTION AND ANALYSIS: Two review authors independently performed a methodological assessment for deciding which studies to include/exclude from the review and extracted data. MAIN RESULTS: From 10 potentially eligible studies, two were included in this review (150 women). Both compared oral rutosides against placebo. Rutosides seem to be effective in reducing the signs identified by the healthcare provider, and symptoms and signs reported by women, of haemorrhoidal disease. For the outcome no response to treatment: relative risk 0.07, 95% confidence interval 0.03 to 0.20. Regarding perinatal outcomes, one fetal death and one congenital malformation (possible not related to exposure) were reported in the control and treatment group respectively. AUTHORS' CONCLUSIONS: Although the treatment with oral Hydroxyethylrutosides looks promising for symptom relief in first and second degree haemorrhoids, its use cannot be recommended until new evidence reassures women and their clinicians about their safety. The most commonly used approaches, such as dietary modifications and local treatments, were not properly evaluated during pregnancy and the puerperium.
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The Cochrane Library - Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium
The Cochrane database of systematic reviews, 2005Co-Authors: Cesar Eugenio Quijano, Edgardo AbalosAbstract:BACKGROUND Haemorrhoids (piles) are swollen veins at or near the anus, normally asymptomatic. They do not constitute a disease, unless they become symptomatic. Pregnancy and the puerperium predispose to symptomatic haemorrhoids, being the most common ano-rectal disease at these stages. Symptoms are usually mild and transient and include intermittent bleeding from the anus and pain. Depending on the degree of pain, quality of life could be affected, varying from mild discomfort to real difficulty in dealing with the activities of everyday life. Treatment during pregnancy is mainly directed to the relief of symptoms, especially pain control. The so-called conservative management includes dietary modifications, stimulants or depressants of the bowel transit, local treatment, and phlebotonics (drugs that cause decreased capillary fragility, improving the microcirculation in venous insufficiency). For many women, symptoms will resolve spontaneously soon after birth, and so any corrective treatment is usually deferred to some time after birth. Thus, the objective of this review is to evaluate the efficacy of conservative management of piles during pregnancy and the puerperium. OBJECTIVES To determine the possible benefits, risks and side-effects of the conservative management of symptomatic haemorrhoids during pregnancy and the puerperium. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 June 2004). SELECTION CRITERIA Randomised-controlled trials comparing any of the conservative treatments for symptomatic haemorrhoids during pregnancy and the puerperium (such as dietary modifications, stimulant/depressant of the bowel transit, local treatments, drugs that improve the microcirculation in venous insufficiency) with a placebo or no treatment. DATA COLLECTION AND ANALYSIS Two review authors independently performed a methodological assessment for deciding which studies to include/exclude from the review and extracted data. MAIN RESULTS From 10 potentially eligible studies, two were included in this review (150 women). Both compared oral rutosides against placebo. Rutosides seem to be effective in reducing the signs identified by the healthcare provider, and symptoms and signs reported by women, of haemorrhoidal disease. For the outcome no response to treatment: relative risk 0.07, 95% confidence interval 0.03 to 0.20. Regarding perinatal outcomes, one fetal death and one congenital malformation (possible not related to exposure) were reported in the control and treatment group respectively. AUTHORS' CONCLUSIONS Although the treatment with oral Hydroxyethylrutosides looks promising for symptom relief in first and second degree haemorrhoids, its use cannot be recommended until new evidence reassures women and their clinicians about their safety. The most commonly used approaches, such as dietary modifications and local treatments, were not properly evaluated during pregnancy and the puerperium.
Ferenc Bánhidy - One of the best experts on this subject based on the ideXlab platform.
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Fetal growth promoting effect of Hydroxyethylrutoside in pregnant women
Open Medicine, 2014Co-Authors: Éva Pósfai, Andrew E. Czeizel, Ferenc BánhidyAbstract:Objective To evaluate the effect of Hydroxyethylrutoside (HER) for fetal development because this flavonoid derivate drug is frequently used in pregnant women for the treatment of vascular diseases.
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Fetal growth promoting effect of Hydroxyethylrutoside in pregnant women
Central European Journal of Medicine, 2014Co-Authors: Éva Pósfai, Andrew E. Czeizel, Ferenc BánhidyAbstract:Objective To evaluate the effect of Hydroxyethylrutoside (HER) for fetal development because this flavonoid derivate drug is frequently used in pregnant women for the treatment of vascular diseases. Method Comparative analysis of exposure (HER treatment) during pregnancy in the newborn infants without any defects born to mothers with or without HER treatment in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities. Main outcomes measures were gestational age at delivery, birth weight, pre- and post-term birth, low and large birth weight. Results Of 38,151 newborn infants, 1,143 (3.0%) were born to mothers with oral HER treatment. The mean birth weight of newborn infants born to mothers with HER was 115 grams larger and is associated with a lower rate of low birth weight and a higher rate of large birth weight. Conclusions Oral HER treatment during pregnancy associates with a fetal growth promotion effect.
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teratogenic effect of Hydroxyethylrutoside a flavonoid derivate drug a population based case control study
Journal of Maternal-fetal & Neonatal Medicine, 2014Co-Authors: Éva Pósfai, Ferenc Bánhidy, Andrew E. CzeizelAbstract:AbstractObjective: Hydroxyethylrutoside (HER), a flavonoid derivate drug, used frequently in pregnant women for the treatment of vascular diseases. The aim of this case–control study was to evaluate the teratogenic potential of oral HER treatment in the population-based Hungarian Case–Control Surveillance System of Congenital Abnormalities.Methods: Comparative analysis of exposure (HER treatment) during pregnancy in the mothers of cases with congenital abnormalities and matched control newborns without any defect in the population-based Hungarian Case–Control Surveillance System of Congenital Abnormalities.Results: Of the 22 843 cases with congenital abnormalities, 567 (2.5%) had mothers with HER treatment while of 38 151 matched controls, 1143 (3.0%) were born to mothers with HER treatment (OR with 95% CI: 0.8, 0.7–0.9). However, an association of HER treatment during the second and/or third month of pregnancy was found with the higher risk of unilateral ocular coloboma (OR with 95% CI: 5.4, 2.2–12.9) an...
Cesar Eugenio Quijano - One of the best experts on this subject based on the ideXlab platform.
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conservative management of symptomatic and or complicated haemorrhoids in pregnancy and the puerperium
Cochrane Database of Systematic Reviews, 2005Co-Authors: Cesar Eugenio Quijano, Edgardo AbalosAbstract:BACKGROUND: Haemorrhoids (piles) are swollen veins at or near the anus, normally asymptomatic. They do not constitute a disease, unless they become symptomatic. Pregnancy and the puerperium predispose to symptomatic haemorrhoids, being the most common ano-rectal disease at these stages. Symptoms are usually mild and transient and include intermittent bleeding from the anus and pain. Depending on the degree of pain, quality of life could be affected, varying from mild discomfort to real difficulty in dealing with the activities of everyday life. Treatment during pregnancy is mainly directed to the relief of symptoms, especially pain control. The so-called conservative management includes dietary modifications, stimulants or depressants of the bowel transit, local treatment, and phlebotonics (drugs that cause decreased capillary fragility, improving the microcirculation in venous insufficiency). For many women, symptoms will resolve spontaneously soon after birth, and so any corrective treatment is usually deferred to some time after birth. Thus, the objective of this review is to evaluate the efficacy of conservative management of piles during pregnancy and the puerperium. OBJECTIVES: To determine the possible benefits, risks and side-effects of the conservative management of symptomatic haemorrhoids during pregnancy and the puerperium. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 June 2004). SELECTION CRITERIA: Randomised-controlled trials comparing any of the conservative treatments for symptomatic haemorrhoids during pregnancy and the puerperium (such as dietary modifications, stimulant/depressant of the bowel transit, local treatments, drugs that improve the microcirculation in venous insufficiency) with a placebo or no treatment. DATA COLLECTION AND ANALYSIS: Two review authors independently performed a methodological assessment for deciding which studies to include/exclude from the review and extracted data. MAIN RESULTS: From 10 potentially eligible studies, two were included in this review (150 women). Both compared oral rutosides against placebo. Rutosides seem to be effective in reducing the signs identified by the healthcare provider, and symptoms and signs reported by women, of haemorrhoidal disease. For the outcome no response to treatment: relative risk 0.07, 95% confidence interval 0.03 to 0.20. Regarding perinatal outcomes, one fetal death and one congenital malformation (possible not related to exposure) were reported in the control and treatment group respectively. AUTHORS' CONCLUSIONS: Although the treatment with oral Hydroxyethylrutosides looks promising for symptom relief in first and second degree haemorrhoids, its use cannot be recommended until new evidence reassures women and their clinicians about their safety. The most commonly used approaches, such as dietary modifications and local treatments, were not properly evaluated during pregnancy and the puerperium.
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The Cochrane Library - Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium
The Cochrane database of systematic reviews, 2005Co-Authors: Cesar Eugenio Quijano, Edgardo AbalosAbstract:BACKGROUND Haemorrhoids (piles) are swollen veins at or near the anus, normally asymptomatic. They do not constitute a disease, unless they become symptomatic. Pregnancy and the puerperium predispose to symptomatic haemorrhoids, being the most common ano-rectal disease at these stages. Symptoms are usually mild and transient and include intermittent bleeding from the anus and pain. Depending on the degree of pain, quality of life could be affected, varying from mild discomfort to real difficulty in dealing with the activities of everyday life. Treatment during pregnancy is mainly directed to the relief of symptoms, especially pain control. The so-called conservative management includes dietary modifications, stimulants or depressants of the bowel transit, local treatment, and phlebotonics (drugs that cause decreased capillary fragility, improving the microcirculation in venous insufficiency). For many women, symptoms will resolve spontaneously soon after birth, and so any corrective treatment is usually deferred to some time after birth. Thus, the objective of this review is to evaluate the efficacy of conservative management of piles during pregnancy and the puerperium. OBJECTIVES To determine the possible benefits, risks and side-effects of the conservative management of symptomatic haemorrhoids during pregnancy and the puerperium. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 June 2004). SELECTION CRITERIA Randomised-controlled trials comparing any of the conservative treatments for symptomatic haemorrhoids during pregnancy and the puerperium (such as dietary modifications, stimulant/depressant of the bowel transit, local treatments, drugs that improve the microcirculation in venous insufficiency) with a placebo or no treatment. DATA COLLECTION AND ANALYSIS Two review authors independently performed a methodological assessment for deciding which studies to include/exclude from the review and extracted data. MAIN RESULTS From 10 potentially eligible studies, two were included in this review (150 women). Both compared oral rutosides against placebo. Rutosides seem to be effective in reducing the signs identified by the healthcare provider, and symptoms and signs reported by women, of haemorrhoidal disease. For the outcome no response to treatment: relative risk 0.07, 95% confidence interval 0.03 to 0.20. Regarding perinatal outcomes, one fetal death and one congenital malformation (possible not related to exposure) were reported in the control and treatment group respectively. AUTHORS' CONCLUSIONS Although the treatment with oral Hydroxyethylrutosides looks promising for symptom relief in first and second degree haemorrhoids, its use cannot be recommended until new evidence reassures women and their clinicians about their safety. The most commonly used approaches, such as dietary modifications and local treatments, were not properly evaluated during pregnancy and the puerperium.
José Remacle - One of the best experts on this subject based on the ideXlab platform.
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Effect of venotropic drugs on the respiratory activity of isolated mitochondria and in endothelial cells.
British journal of pharmacology, 2000Co-Authors: Dominique Janssens, José Remacle, Edouard Delaive, Andrée Houbion, François Eliaers, Carine MichielsAbstract:Several drugs used in the treatment of chronic peripheral ischaemic and venous diseases, i.e. aescine, Cyclo 3, Ginkor Fort, Hydroxyethylrutosides, naftidrofuryl, naphthoquinone and procyanidolic oligomers, were tested on the mitochondrial respiratory activity. The results show that all these drugs protected human endothelial cells against the hypoxia-induced decrease in ATP content. In addition, they all induced a concentration-dependent increase in respiratory control ratio (RCR) of liver mitochondria pre-incubated with the drugs for 60 min. The drugs were divided into two groups according to their effects. The first group (A), comprising aescine, Ginkor Fort, naftidrofuryl and naphthoquinone, increased RCR by decreasing state 4 respiration rate. The second group of drugs (B), comprising Hydroxyethylrutosides, procyanidolic oligomers and Cyclo 3, increased RCR by increasing state 3 respiration rate. The drugs of group A were able to prevent the inhibition of complexes I and III respectively by amytal and antimycin A while the first two drugs of group B increased adenine nucleotide translocase activity. Cyclo 3 inhibited the carbonylcyanide m-chlorophenyl hydrazone (mCCP)-induced uncoupling of mitochondrial respiration. None of these seven drugs could protect complexes IV and V, respectively, from inhibition by cyanide and oligomycin. When tested on endothelial cells the drugs of group A, in contrast to group B, prevented the decrease in ATP content induced by amytal or antimycin A. The present results suggest that the protective effects on mitochondrial respiration activity by these venotropic drugs may explain their protective effect on the cellular ATP content in ischaemic conditions and some of their beneficial therapeutic effect in chronic vascular diseases. Keywords: Venotropic drugs, hypoxia, endothelial cells, mitochondria, respiration, cellular, phosphorylation, oxidative, adenine nucleotide translocase Introduction Vascular diseases affect a high proportion of the population in developed countries. They vary in nature, including such conditions as arteritis, thrombosis, myocardial infarction, cerebral ischaemia and chronic venous insufficiency. All of these diseases are associated with more or less pronounced ischaemic conditions. Chronic venous insufficiency is one of these vascular diseases. A possible mechanism for the development of varicose veins was recently described to explain the irreversible changes occurring in the vessel wall (Michiels et al., 1997). The pathological activation of endothelial cells by ischaemic conditions developing during blood stasis has been proposed to play a key role in this process (Michiels et al., 1994). The initial event of the pathological activation of endothelial cells by hypoxia in vitro is a decrease in intracellular ATP content which leads to an increase in cytosolic calcium concentration (Arnould et al., 1992). This decrease is due to a decrease in mitochondrial respiration. Calcium can then induce the activation of phospholipase A2, which is responsible for an increase in the synthesis of prostaglandins and of platelet-activating factor (Michiels et al., 1993a). This process results in an increase in endothelial cell adhesiveness for neutrophils (Arnould et al., 1993) and to the subsequent activation of these blood cells (Arnould et al., 1993; 1994). Hypoxia is thus able to initiate, via an active role of the endothelium, an inflammatory response which then initiates and promotes tissue damage. According to this hypothesis, preservation of ATP regeneration by drugs should prevent the hypoxia-induced endothelial activation and, hence, would protect tissue from subsequent alteration. The critical role played by mitochondria in the maintenance of cellular energy metabolism has long been recognized (Jennings & Ganote, 1976; Trump et al., 1976). Electron transport from the oxidation of reduced nicotinamide adenine dinucleotide (NADH) and reduced flavin adenine dinucleotide (FADH2) to O2 is tightly coupled to the synthesis of ATP. The electron transport occurs through protein-bound redox centres, from complex I (NADH-Coenzyme Q reductase) or II (succinate-Coenzyme Q reductase) to III (Coenzyme Q-cytochrome c reductase) and then to IV (cytochrome c oxidase). The free energy released by this transport is conserved by pumping out protons in order to create an electrochemical H+ gradient across the inner mitochondrial membrane. The electrochemical potential of this gradient is then harnessed in the synthesis of ATP by complex V (ATP synthase): this process is known as oxidative phosphorylation. In ischaemic conditions it has been established that, in a large number of organs, there is a relationship between mitochondrial dysfunction and the irreversibility of pathological damage (Veitch et al., 1992; Allen et al., 1995). Indeed, the transition from reversible to irreversible ischaemia is probably dependent on the functional state of mitochondria (Jennings, 1969; Taegtmeyer et al., 1985). Mitochondria have been shown to be altered both morphologically and functionally in ischaemic organs (Yanagiya, 1994), while ischaemia induces a decrease in the respiratory activity of mitochondria in several species, mainly at the level of NAD+-dependent substrate (Almeida et al., 1995). Damage occurring in mitochondria during ischaemia is associated with a loss of respiratory activity of complex I in the electron transport chain; the activity of complex III is also altered but this occurs at later time points. A decrease in NADH-ubiquinone reductase and adenine nucleotide translocase activities and in cytochromes a and a3 and cytochromes c and c1 then leads to complete loss of respiratory activity (Duan & Karmazyn, 1989; Veitch et al., 1992). These alterations finally result in mitochondrial swelling and ultrastructural alterations such as convolutions of the mitochondrial inner membrane and appearance of amorphous dense bodies in the matrix (Yanagiya, 1994). In addition to these processes, an increase in mitochondrial calcium content is observed during and after hypoxia (Silverman, 1993). This phenomenon may be responsible for cytochrome c release (Borutaite et al., 1999), matrix swelling through opening of the permeability transition pore (Saris et al., 1998), respiratory uncoupling (Lemasters et al., 1997) or calcium cycling and collapse of the proton-motive force (Richter & Frei, 1988). However, the significance of this increase for the ischaemic impairment of respiratory activity remains controversial. The understanding of the mechanism through which many of the drugs claimed to be beneficial in chronic venous insufficiency and arteriopathy work is currently not known; this is particularly true for drugs derived from plant extracts. In this work, some of these drugs were tested in order to investigate whether they could protect the cellular ATP content in hypoxic conditions and whether they have a direct effect on mitochondrial respiration. In a previous study we showed that bilobalide, a molecule present in one of these drugs, Ginkor Fort, could prevent the hypoxia-induced decrease in ATP content in endothelial cells. This effect was explained by an increase in the respiratory activity of isolated mitochondria (Janssens et al., 1995). Other studies also showed that three other drugs (aescine, Hydroxyethylrutosides and naftidrofuryl) used in the treatment of chronic venous insufficiency or arteriopathy could also prevent the ATP decrease induced by hypoxia in cultured endothelial cells (Arnould et al., 1996; Janssens et al., 1996; Michiels et al., 1993a). Since the mechanism of this protection is not known, we investigated here the effect of these drugs, as well as some others also used in the treatment of chronic venous insufficiency or of arteriopathy, on the respiratory activity of isolated mitochondria. In addition, their effects on the different complexes of the respiratory chain were studied.
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Effect of Hydroxyethylrutosides on Hypoxial-Induced Neutrophil Adherence to Umbilical Vein Endothelium
Cardiovascular Drugs and Therapy, 1998Co-Authors: Isabelle H. Roland, Catherine Bougelet, Noelle Ninane, Thierry Arnould, Carine Michiels, José RemacleAbstract:A clinically available mixture of Hydroxyethylrutosides (HR) was examined as a protector against endothelial cell activation by hypoxia in perfused human umbilical vein. The results showed that 500 μg/mL HR totally inhibited the adherence of human unstimulated neutrophils to the endothelium of umbilical vein incubated in hypoxic conditions. This inhibition was confirmed by a morphological study performed by scanning electron microscopy. In addition, neutrophils adherent to the hypoxic umbilical vein endothelium became activated, as evidenced by the increased release of superoxide anions and synthesis of leukotriene B4. These processes could also be inhibited by HR. In conclusion, the results of this study suggest that the improvement in venous insufficiency observed clinically with HR could, in part, be the result of their ability to inhibit the recruitment and activation of neutrophils by endothelium activated during blood stasis.
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Effects of Hydroxyethylrutosides on hypoxia-induced activation of human endothelial cells in vitro.
British journal of pharmacology, 1996Co-Authors: Dominique Janssens, Thierry Arnould, Carine Michiels, José RemacleAbstract:1. A clinically available mixture of Hydroxyethylrutosides (HR) was examined as inhibitors of endothelial cell activation by hypoxia in vitro. Thus, the effects of HR on ATP depletion, phospholipase A2 activation and neutrophil adherence were investigated in hypoxia-activated human umbilical vein endothelial cells in primary cell culture. 2. Our results show that HR inhibited two important steps of the activation of endothelial cells by hypoxia: the decrease in ATP content, which is the starting point of the process, and the activation of phospholipase A2 one enzyme responsible for the release of inflammatory mediators. This inhibition was dose-dependent with 70 to 90% inhibition at 500 micrograms ml-1 of HR. 3. In addition, hypoxia-activated endothelial cells increased their adhesiveness for neutrophils. This process could also be prevented in a dose-dependent manner if endothelial cells were incubated in the presence of HR. This inhibition was confirmed by a morphological study. 4. In conclusion, the results of this study suggest that a possible explanation for the improvement in venous insufficiency by HR observed clinically could be their ability to inhibit the activation of endothelial cells during blood stasis.
Éva Pósfai - One of the best experts on this subject based on the ideXlab platform.
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Fetal growth promoting effect of Hydroxyethylrutoside in pregnant women
Open Medicine, 2014Co-Authors: Éva Pósfai, Andrew E. Czeizel, Ferenc BánhidyAbstract:Objective To evaluate the effect of Hydroxyethylrutoside (HER) for fetal development because this flavonoid derivate drug is frequently used in pregnant women for the treatment of vascular diseases.
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Fetal growth promoting effect of Hydroxyethylrutoside in pregnant women
Central European Journal of Medicine, 2014Co-Authors: Éva Pósfai, Andrew E. Czeizel, Ferenc BánhidyAbstract:Objective To evaluate the effect of Hydroxyethylrutoside (HER) for fetal development because this flavonoid derivate drug is frequently used in pregnant women for the treatment of vascular diseases. Method Comparative analysis of exposure (HER treatment) during pregnancy in the newborn infants without any defects born to mothers with or without HER treatment in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities. Main outcomes measures were gestational age at delivery, birth weight, pre- and post-term birth, low and large birth weight. Results Of 38,151 newborn infants, 1,143 (3.0%) were born to mothers with oral HER treatment. The mean birth weight of newborn infants born to mothers with HER was 115 grams larger and is associated with a lower rate of low birth weight and a higher rate of large birth weight. Conclusions Oral HER treatment during pregnancy associates with a fetal growth promotion effect.
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teratogenic effect of Hydroxyethylrutoside a flavonoid derivate drug a population based case control study
Journal of Maternal-fetal & Neonatal Medicine, 2014Co-Authors: Éva Pósfai, Ferenc Bánhidy, Andrew E. CzeizelAbstract:AbstractObjective: Hydroxyethylrutoside (HER), a flavonoid derivate drug, used frequently in pregnant women for the treatment of vascular diseases. The aim of this case–control study was to evaluate the teratogenic potential of oral HER treatment in the population-based Hungarian Case–Control Surveillance System of Congenital Abnormalities.Methods: Comparative analysis of exposure (HER treatment) during pregnancy in the mothers of cases with congenital abnormalities and matched control newborns without any defect in the population-based Hungarian Case–Control Surveillance System of Congenital Abnormalities.Results: Of the 22 843 cases with congenital abnormalities, 567 (2.5%) had mothers with HER treatment while of 38 151 matched controls, 1143 (3.0%) were born to mothers with HER treatment (OR with 95% CI: 0.8, 0.7–0.9). However, an association of HER treatment during the second and/or third month of pregnancy was found with the higher risk of unilateral ocular coloboma (OR with 95% CI: 5.4, 2.2–12.9) an...
