Neuroleptic malignant syndrome in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Pharmacology

Background:

• Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication of antipsychotic medication.
• Antipsychotic drug use during pregnancy presents unique challenges for managing maternal and fetal health.
• Identifying NMS in pregnant patients requires careful consideration of clinical presentation and medication history.

Observation:

• A pregnant patient with varicella pneumonia developed NMS after receiving haloperidol (Haldol) for agitation.
• Clinical signs included fever, increased agitation, muscle rigidity, tachycardia, and tremors.
• The patient required intensive care unit admission for management.

Findings:

• Successful treatment of NMS in pregnancy was achieved using bromocriptine and dantrolene.
• Prompt diagnosis and intervention are crucial for managing NMS during pregnancy.
• This case highlights the importance of considering NMS in pregnant patients presenting with specific symptoms after antipsychotic exposure.

Implications:

• Antipsychotic medications should be used cautiously in pregnant patients, with careful monitoring for NMS symptoms.
• Bromocriptine and dantrolene represent effective treatment options for NMS in pregnant women.
• Increased awareness and diagnostic vigilance for NMS in pregnancy are warranted among healthcare providers.