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.