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Journal of Case Reports
Antenatally Diagnosed Binder Syndrome in Newborn Following Maternal Warfarin Intake in First Trimester
Renuka Malik, Garima Agarwal
Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research and RML Hospital, New Delhi 110001, India. 
Corresponding Author:
Dr. Renuka Malik
Email: renucam@yahoo.co.in
Received: 16-DEC-2015 Accepted: 06-JAN-2016 Published Online: 25-JAN-2016
DOI: http://dx.doi.org/10.17659/01.2016.0010
The primary physical characteristic of Binder syndrome is midfacial hypoplasia and flattened nose associated with the absence of the anterior nasal spine. Binder syndrome is a rare developmental defect which has many etiologies including vitamin K deficiency which may occur following warfarin intake during first trimester. It is rare disorder occurring in less than 1 per 10,000 live births.  Common differential diagnosis includes CDPR (chondrodysplasia punctata, rhizomelic type) and fetal warfarin syndrome. We hereby report a case diagnosed antenatally as Binder syndrome in a fetus of woman suffering from rheumatic heart disease, who took warfarin in first trimester because of mechanical mitral valve prosthesis. This case is presented to highlight the teratogenic potential of warfarin and importance of preconceptional counseling by cardiologist and obstetrician and also to suggest the role of vitamin K deficiency in facial dysmorphism in Binder Syndrome.
Keywords : Drug Induced Abnormalities, Cataract, Pregnancy, Rheumatic Heart Disease, Vitamin K Deficiency, Warfarin.
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