Vitamin K-Antagonist: An Illegal Means to Terminate Pregnancy?

Introduction: In Germany the number of terminations of pregnancies including not officially reported terminations is estimated to run to more than 200000 annually. Both surgical procedures and medications are used to legally terminate pregnancies. It is assumed that these procedures are also used for illegal terminations. Historically, the use of many different procedures has been reported. To date, however, therewere no reports of the illegal use of other ordinary medications to terminate pregnancy. Methods: Severe intoxication with a vitamin K-antagonist during pregnancy has been reported in two cases. The current legal and historical means of terminating pregnancy and the associated complications are presented here. Results: After excluding other reasons it must be assumed that in both cases either the pregnant patient herself or another person was responsible for the intoxication with the aim of terminating the pregnancy. In view of the historical precedents, intoxication with a vitamin K-antagonist with the intention of terminating a pregnancy appears to offer a new illegal means of termination, using a medication developed for a completely different purpose and which may, moreover, result in many complications. Conclusion: Physicians should be aware of this possibility as a rare differential diagnosis in special cases.