Snake envenomation during pregnancy

Main Article Content

Denisse G Martinez
Newton G Osborne

Abstract

Background: We report our experience with management and treatment of pregnant women who were admitted at our institution for snake envenomation.


Methosd: We reviewed the charts and recorded the management, treatment, and outcome of 51 pregnant women admitted to our high-risk obstetric service with a diagnosis of snakebite.


Results: One patient experienced spontaneous abortion, 2 had intrauterine fetal death due to placental abruption, 2 delivered malformed babies, 1 had premature birth of twins with low birthweight. There were no maternal deaths.


Conclusion: Snake-venom poisoning in pregnancy is a complex medical emergency that involves complications at the site of the bite and may also involve dysfunction of multiple organ systems in both mother and fetus.

Article Details

Martinez, D. G., & Osborne, N. G. (2019). Snake envenomation during pregnancy. Clinical Journal of Obstetrics and Gynecology, 2(2), 150–155. https://doi.org/10.29328/journal.cjog.1001039
Research Articles

Copyright (c) 2019 Martínez DG, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Gutiérrez JM. Envenenamientos por mordeduras de serpientes en América Latina y el Caribe: una visión integral de carácter regional. Bol Malariol Salud Amb. 2011; 51: 1–16.

Vélez SM, Salazar M, Acosta de Patiño H, Gómez L, Rodriguez A, et al. Geographical variability of the venoms of four populations of Bothrops asper from Panama: toxicological analysis and neutralization by a polyvalent antivenom. Toxicon. 2017; 132: 55–61. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28392273

Gold BS, Dart RC, Barish RA. Bites by venomous snakes. N Engl J Med. 2002; 347: 347-356. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12151473

Wingert WA, Chan L. Rattlesnake bites in Southern California and rationale for recommended treatment. West J Med .1988; 148: 37-44. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1026007/

Pecchioa M, Suárez JA, Hessec S, Hershd AM, Gundackere ND. Descriptive epidemiology of snakebites in the Veraguas province of Panama, 2007–2008. Trans R Soc Trop Med Hyg. 2018; 112: 463–466. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30165536

Gold BS, Wingert WA. Snake venom poisoning in the United States: a review of therapeutic practice. South Med J. 1994; 87: 579-589. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8202764

Saade GR, Foley MR, Phelan JP y Dildy GA. Critical Care Obstetrics. USA: Wiley. 2010; 550.

Bergillo F, Rivas MA. Toxinología clínica. Lesiones por picaduras y mordeduras de animales. Bubok Publishing. 2013; 531.

Acosta H. Programa Nacional de Ofidismo y Escorpionismo. Perspectivas hacia la respuesta nacional. Panamá. [Internet]. 2017 [cited 2019 March 15]: https://www.senacyt.gob.pa/wp-content/uploads/2018/07/Ofidismo-y-Escorpionismo-Hildaura-Acosta.pdf

Seneviratne SL1, de Silva CE, Fonseka MM, Pathmeswaran A, Gunatilake SB, et al. Envenoming due to snake bite during pregnancy. R Soc Trop Med Hyg. 2002; 96: 272-274. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12174776

Langley RL. Snakebite during Pregnancy: A Literature Review. Wilderness Environ Med. 2010; 21: 54–60. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20591355

Dunnihoo DR, Rush BM, Wise RB, Brooks GG, Otterson WN. Snake bite poisoning in pregnancy. A review of the literature. J Reprod Med 1992; 37: 653‒658. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/1522574

Padmaja DA. Snake bite in pregnancy-case report and review of literature. Int J Pregn & Chi Birth. 2017; 2: 21‒23.

Hanprasertpong J, Hanprasertpon T. Abruptio placentae and fetal death following a Malayan pit viper bite. J Obstet Gynaecol Res. 2008; 34: 258-261. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18412793

Mittal R, Dhiman B, Sood N, Sood S. A rare case of pregnancy complicated by snake bite. Int J Reprod Contracept Obstet Gynecol. 2016; 5: 243-245.

Satish H, Jayachandran S, Priyamvada PS, Keepanasseril A, Sravankumar J, et al. Snakebite-induced acute kidney injury requiring dialysis in second trimester of pregnancy: Successful outcomes in a therapeutic quagmire. Saudi J Kidney Dis Transpl. 2017; 28: 437-440. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28352037

Nelwan E, Adiwinata R, Handayani S, Rinaldi I. Severe coagulopathy and transient hypertension following a Rhabdophissubminiatus bite: a case report. Revista da Sociedade Brasileira de Medicina Tropical. 2016; 49: 520-522. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27598644