Mother and fetus both survive from severe paraquat intoxication.
Paraquat, 1,1'-dimethyl-4,4'-bipyridylium dichloride, is a commonly applied bipyridyl contact herbicide. Paraquat poisoning from suicidal ingestion causes high mortality rates, and severe poisoning has been uniformly fatal in pregnant females (nine of nine cases). We presented a case of severe paraquat poisoning from suicidal ingestion in a woman in the third trimester of pregnancy (G5P4A1). Urine dithionate test was strongly positive (showed dark blue color). She was managed with charcoal hemoperfusion x 2, megadose of cyclophosphamide, and methylprednisolone pulse therapy. Despite initial deterioration of renal and liver function, she had a normal spontaneous delivery of a healthy girl baby 14 weeks after the exposure. The child reached developmental milestones normally and appeared healthy and well nourished at age 5. This may be the first documentation of a pregnant woman with moderate to severe paraquat poisoning successfully delivering a healthy baby.
Jenq
Chang-Chyi
CC
Poison Center and Division of Clinical Toxicology, Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan, R.O.C.
Wu
Chien-Der
CD
Lin
Ja-Liang
JL
D000328:Adult; D000477:Alkylating Agents / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D001784:Blood Gas Analysis; D002606:Charcoal / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005333:Fetus / Q000502:physiology; D006464:Hemoperfusion; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D010269:Paraquat / Q000506:poisoning*; D011247:Pregnancy; D020551:Pulse Therapy, Drug; D013406:Suicide, Attempted
D000477:Alkylating Agents; D000893:Anti-Inflammatory Agents; D006540:Herbicides; D002606:Charcoal; D003907:Dexamethasone; D003520:Cyclophosphamide; D003404:Creatinine; D010269:Paraquat; D008775:Methylprednisolone