Poisonings and toxins

Yates, LM; Stephens, S

doi:10.1016/B978-0-12-408078-2.00023-8

Poisonings and toxins

Lookup NU author(s): Dr Laura Yates ORCiD, Dr Sally Stephens

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.

Abstract

© 2015 Elsevier B.V. All rights reserved. Poisoning in pregnancy may be accidental or intentional, acute or chronic and may involve one or more substances. Risk to both mother and fetus will depend primarily on the nature of the exposure(s), as well as the gestation at which the poisoning occurred, the presence of maternal toxicity and the time interval between poisoning and maternal treatment. A thorough assessment of both the maternal and fetal conditions and possible risk should be made at presentation, and then again following treatment of maternal symptoms. Poisoning in pregnancy is uncommon and published data on maternofetal outcome even scarcer, and often outdated in terms of therapies used. For this reason evidence-based guidelines on the treatment of pregnant women who have been poisoned do not exist. Experience from specialist poisons and teratology centers worldwide, and from analysis of case reports, or small case series on specific exposures, suggest that in most situations treatment of the poisoned pregnant patient should be as for the nonpregnant patient. Where clinically indicated, administration of antidotes or other interventions should not be delayed or withheld because of concerns regarding teratogenic effects. Fetal well-being should, however, be considered during any interventions and procedures. Although the fetal effects of most antidotes are poorly documented, any theoretical risks to the fetus are likely to be less than those associated with failing to treat the mother adequately. Until details of episodes of poisoning in pregnancy are accurately documented and systemically recorded to enable longer term follow up of maternal and fetal outcome, evidence based guidance regarding treatment in pregnancy is likely to remain lacking.