title: Intrauterine fetal death caused by pit viper venom poisoning in early pregnancy.
abstract: Poisonous snakebite is a rare complication of pregnancy. It has been suggested that snakebite poisoning during pregnancy may cause fetal loss. We report a case of intrauterine fetal death after a poisonous snakebite in the first trimester of pregnancy. A 29-year-old pregnant Japanese woman was admitted to hospital after being bitten by a pit viper on her right heel. The patient was at 10 weeks of gestation. In response to the bite, her right leg became extremely swollen, and paralysis of the right oculomotor nerve was observed. Intravenous administration of cepharanthine, ulinastatin, hydrocortisone sodium succinate, gabexate mesylate and antibiotics was started. Laboratory data suggested the presence of rhabdomyolysis. One week after admission, although she improved clinically and symptomatically, transvaginal ultrasonography revealed intrauterine fetal death. No vaginal bleeding was observed. A dilatation and curettage was performed. The patient made an uneventful recovery and was discharged from hospital 17 days after the snakebite. Consistent with other reports, in the first trimester intrauterine fetal death may especially occur when the mother has systemic symptoms, although its mechanism remains unclear.
authors.affiliation: Department of Obstetrics and Gynecology, Oita Medical University, Oita, Japan. nasu@oita-med.ac.jp
authors.forename: Kaei
authors.initials: K
authors.lastname: Nasu
authors.forename: Tami
authors.initials: T
authors.lastname: Ueda
authors.forename: Isao
authors.initials: I
authors.lastname: Miyakawa
mesh_terms: D000328:Adult; D017836:Agkistrodon; D000818:Animals; D002097:C-Reactive Protein / Q000032:analysis; D003435:Crotalid Venoms / Q000506:poisoning*; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D007964:Leukocytosis / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000209:etiology; D011261:Pregnancy Trimester, First; D012206:Rhabdomyolysis / Q000209:etiology; D012909:Snake Bites / Q000150:complications* / Q000188:drug therapy; D012911:Snakes
chemical_list: D003435:Crotalid Venoms; D002097:C-Reactive Protein