Abruptio placentae and fetal death following a Malayan pit viper bite

Reports of venomous snakebites during pregnancy are uncommon. Little is known about maternal and fetal outcome following the venomous snakebite of a pregnant woman, and there is no consensus for proper management. In southern Thailand, Malayan pit viper (Calloselasma rhodostoma) bites are quite common, and we have some experience with bites of pregnant women. With these victims, the toxicity is most severely expressed in a bleeding disorder that is a significant cause of both morbidity and mortality in both the gravid woman and the fetus. Herein, because there are few such published reports, we report the case of a 43-year-old woman, gravida 5 para 4, 32 weeks pregnant who was bitten by a Malayan pit viper and, as a result, developed abruptio placentae, coagulopathy, and death of fetus in utero. She otherwise responded well to antivenom and blood components. A hysterotomy was performed and the postoperative course was unremarkable.