Isotretinoin and pregnancy - How big is the risk of having a baby with problems?

Dear Ask The Doctor: Hello, I started taking isotretinoin (5 mg) when I found out that I was 6 weeks pregnant. I took somethinh like 7 pills, no more than that. How big is the risk of having a baby with problems? Thanks in advance. Anna

Dear Ana: Isotretinoin is contraindicated during pregnancy. Females of childbearing potential should not become pregnant during therapy or for 1 month following discontinuation of isotretinoin. Major fetal abnormalities (both internal and external), spontaneous abortion, premature births and low IQ scores in surviving infants have been reported. It is difficult for me to tell you how big is the risk. I would recommend following up with your doctor. A special ultrasound done in the second trimester of pregnancy may be able to see if a birth defect has been caused by exposure to isotretinoin. Ultrasound can detect many birth defects but it cannot tell if a child may have learning or developmental problems.