[Side-effects of drugs].

other epidemiological characteristics and both lived in an area where hepatitis A is highly endemic. The low prevalence of anti-HAV in patients with thalassaemia is unlikely to be due to a resistance to the infection endowed by the disease, since an increased prevalence of anti-HBs as well as of antibodies to cytomegalovirus and other viruses has been found in such children." Thus regular blood transfusion probably gives sufficient protection against HAV under usual conditions of exposure, postponing infection until later in life. The inverse relationship between the number of blood transfusions and the prevalence of HAV infections further supports this view. Transfusions may produce passive immunity-anti-HAV protects against re-infection by HAV both experimentally in man and animals2 315 and clinically when given immune globulin.'5 The protection given to patients with thalassaemia should be highly efficient under the usual conditions of exposure, since they are trans-fused almost every month with blood from donors who are nearly all anti-HAV positive."9 The prevalence of HBV infections in contrast presumably increases with the number of blood transfusions because only about 20-25% of Greek blood donors have anti-HBs-but also because passively acquired anti-HBs cannot protect adequately against the enormous amount of HBV transmitted in a unit of blood positive for HBsAg.2" The correlation between the prevalence of HAV and HBV infections in controls suggests that certain factors such as poor hygienic conditions increase the risk of exposure to both viruses.21 The inverse relationship observed in the patients with thalassaemia underlines the importance of blood transfusion in the transmission of HBV and its ability to protect against HAV infection. Unusual fetal malformations after antiemetics in early pregnancy Debendox (dicyclomine hydrochloride 10 mg, doxylamine succinate 10 mg, pyridoxine hydrochloride 10 mg) is widely prescribed for nausea and vomiting in pregnancy and is generally regarded as non-teratogenic, though reduction deformities in infants whose mothers have taken the drug have occasionally been reported.' We describe three patients who took Debendox from an unusually early stage of pregnancy and subsequently gave birth to babies with a rare combination of abnormalities, including extrusion of abdominal contents and reduction deformity or total absence of a leg. The women lived in widely separated areas of the northwest of England and the babies were born between July 1975 and May 1977. Case reports Case 1-A 24-year-old primigravida with a regular menstrual history (4/28-32) took one Debendox tablet each morning and two at night for …