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Severe congenital disabilities can occur with Accutane usage during pregnancy, including: Hearing and visual impairment Missing or malformed earlobes Brain function abnormalities Facial dysmorphisms, such as small or missing eyes or a cleft palate Congenital heart defects Hydrocephalus (fluid and pressure buildup on the brain) Any patient who can become pregnant must use two effective forms of birth control during treatment or commit to abstinence