Pre-Labor exposure to carbon monoxide: should the neonate be treated with hyperbaric oxygenation?
A woman was admitted to hospital in the 39th week of gestation due to syncope, followed by nausea and headache. The patient's history revealed a 10-hour, unintentional exposure to carbon monoxide (CO), secondary to burning charcoal for indoor heating. Because of monitored fetal distress, a cesarean section was performed. The newborn had an Apgar score of 4, 9, and 10 at 1, 5, and 10 minutes post-delivery, respectively. The 1-minute Apgar was low due to lack of spontaneous breathing, reduced tonus, bluish coloration, and reduced response to pain. The neonate's carboxyhemoglobin level seven hours post-CO exposure was 22%, and arterial pH was 7.28. Neurological examination 30 minutes after delivery showed no pathology. The neonate was treated with 100% normobaric oxygen for 12 hours. We discuss the treatment options for fetal CO poisoning and specific considerations that had to be taken into account in the present case.
Bar
Ronen
R
Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel. bar1906@netvision.net.il
Cohen
Maxim
M
Bentur
Yedidia
Y
Shupak
Avi
A
Adir
Yochai
Y
D000328:Adult; D002249:Carbon Monoxide Poisoning / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure; D010102:Oxygen Inhalation Therapy; D011247:Pregnancy