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Poisoning in Pregnancy

  • Kevin F. MaskellJr.
  • Kirk L. Cumpston
  • Timothy B. Erickson
  • Jerrold B. Leikin
Reference work entry

Abstract

It has been said that managing a pregnant patient involves managing two patients at once, the mother and the fetus. This dual management paradigm is often seen as a complex balancing act, benefits to the mother against risks to the fetus and vice versa. In the setting of poisoned patients, this takes on an even greater complexity, especially given the relative lack of literature to support or refute any given treatment recommendation. The higher acuity of the critically ill patient brings this situation to its sharpest point as the death of mother, fetus, or both becomes an ever more likely possibility. This chapter will discuss specific recommendations in greater detail, but as a general rule, the best approach to all poisoned pregnant patients is to treat the mother in the same way as if she were not pregnant. Improved maternal survival will typically lead to improved fetal survival.

Keywords

Pregnancy Teratology Teratogenicity Intrauterine growth retardation Premature delivery Fetal demise Placental abruption Carbon monoxide Valproic acid Trimethadione Phenytoin Thalidomide Warfarin Isotretinoin Placenta Activated charcoal Whole-bowel irrigation Antidotes Abortifacients Acetaminophen N-Acetylcysteine Salicylates Iron Deferoxamine Cyanide Hydroxycobalamin Sodium nitrite Sodium thiosulfate Cocaine Opioids Opioid withdrawal Magnesium sulfate Methotrexate Oxytocin 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Clinical Toxicology, Department of Emergency MedicineVirginia Commonwealth University Health System, RichmondVAUSA
  2. 2.Division of Medical Toxicology, Department of Emergency MedicineBrigham and Women’s Hospital Faculty, Harvard Medical School and Harvard Humanitarian InitiativeBostonUSA
  3. 3.University of Chicago Pritzker School of MedicineGlenviewUSA

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