Toxic ingestions in pregnancy: abortifacient use in a case series of pregnant overdose patients.
OBJECTIVE
To profile young, pregnant patients with an overdose reported to an urban poison center; and to characterize the ingestions and short-term outcomes of these overdose patients.


METHODS
A prospective, observational study of female overdose patients was performed from November 1, 1994, through March 31, 1995. Consecutive cases were identified from all calls to the regional poison center (annual call volume = 70,000) regarding intentional overdose in women between the ages of 12 and 30 years. Pregnancy tests were recommended by the poison center during the study period in female patients aged 12-30 years who presented to a health care facility (usually an urban ED) with an intentional overdose. Pregnant patients were then followed during their hospitalizations, and the results of toxicology studies and maternal and short-term fetal outcomes were recorded.


RESULTS
Pregnancy tests were obtained for 371 (32%) of 1,142 eligible patients. Of patients with pregnancy tests, 43 (11.6%) were pregnant. Although most cases were comparable to general adult intentional ingestions, 5 of the 43 pregnant patients ingested known abortifacients. Most pregnant patients (35/43, 81%) had toxicity at or below American Association of Poison Control Centers (AAPCC) criteria for minimal toxicity, and all patients recovered completely.


CONCLUSIONS
Pregnancy was a common finding in this sample of young, female, intentional overdose patients reported to our regional poison control center. Frequent use of abortifacients for toxic ingestions has not been previously reported. A pregnancy test should be obtained for all female patients of childbearing age with an intentional ingestion to address the potential association of the ingestion with an unanticipated or undesired pregnancy.
Perrone
J
J
Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104, USA. jeanmari@mail.med.upenn.edu
Hoffman
R S
RS
D000019:Abortifacient Agents / Q000506:poisoning*; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002648:Child; D062787:Drug Overdose / Q000453:epidemiology; D005260:Female; D006801:Humans; D009519:New York City / Q000453:epidemiology; D011039:Poison Control Centers; D011247:Pregnancy; D011256:Pregnancy Outcome; D011258:Pregnancy Tests; D011446:Prospective Studies; D014505:Urban Population
D000019:Abortifacient Agents