Association of clomiphene with iniencephaly.

This 23-year-old primigravida had history of having taken Clomiphene for 2 consecutive cycles starting on day 5 of her menstrual cycle (50 mg for five days). After the 2nd cycle of clomiphene, she became pregnant. There was no history of taking any other drug for infertility or folate tablets periconceptionally. An ultrasound at 20 weeks showed neural tube defect. At 22 weeks of gestation, she delivered a 300 grams abortus spontaneously. It was an Iniencephalus female fetus who had fusion of the occiput to the cervical spine and retroflexion of the head with an exaggerated lumbar lordosis. The fetus also had an umbilical hernia, clubfoot, micrognathia, and cleft palate. The thoracic and cervical spine were abnormal with spinal dysraphism. The lumbar and sacral vertebrae were normal. The head was hyperextended, mandible hypoplastic, cranial bones incomplete and ribs deformed and crowded.