Mycophenolate mofetil: Emerging as a potential human teratogen

QUESTION: One of my female patients conceived 2 years after renal transplant while using mycophenolate mofetil. She only realized she was pregnant at 14 weeks of gestation. How should I advise her? ANSWER: Several recent case series show increased malformation rates with mycophenolate mofetil. Specifically, the repeated occurrence of phenotypic presentations of ear malformations, cleft lip and palate, and other malformations suggest that this is not by chance alone.