1313 A CASE OF MURCS ASSOCIATION AFTER EXPOSURE TO CIMETIDINE IN UTERO

MURCS Association consists of Mullerian Duct. Renal, and Cervical Vertebral defects. A 30-year-old mother took cimetidine, 200 me 4 times daily, during the first month of gestation and gave birth at term to a daughter with an absent vaginal opening, fusion of the cervical vertebra, and clubfeet. No uterus was palpated on rectal examination. The child is otherwise in good health with normal intelligence. Her chromosome studies were normal as were her parent's. Family history is negative for birth defects but positive for increased fetal wastage. The patient has three normal male siblings.As this is a single case report and the affected person is a female, the association may be entirely coincidental. However, cimetidine is widely used. It is intriguing that intrauterine exposure to cimetidine in rats followed by neonatal exposure results in hypoandrogenization in adult males. In humans cimetideine in vitro blocks the positive chronotropic and ventricular iontropic effects of histamine on the fetal heart. In a single case report, doses up to 1 gm. per day caused no adverse effect on the fetus. No association between intrauterine cimetidine exposure and abnormal sexual differentiation in man has been reported to our knowledge. Limetidine should be used with caution in pregnancy.