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Carbon Monoxide Exposure During Pregnancy.
Perry Friedman1, Xiaoyue M Guo2, Robert J Stiller3
1Resident Physician, Department of Obstetrics and Gynecology, Bridgeport Hospital, Bridgeport.
Obstetrical & Gynecological Survey
|November 21, 2015
Summary
Carbon monoxide (CO) poisoning during pregnancy is a serious risk, often missed due to vague symptoms. Prompt diagnosis and treatment, including oxygen therapy, are crucial for maternal and fetal well-being.
Area of Science:
- Toxicology
- Obstetrics and Gynecology
- Environmental Health
Background:
- Carbon monoxide (CO) poisoning is a leading cause of poisoning in the United States, posing significant risks to maternal and fetal health.
- Nonspecific signs and symptoms of CO toxicity can lead to delayed or missed diagnoses, attributing cases to other conditions.
- Adverse effects of CO on both mother and fetus necessitate timely recognition and management by healthcare practitioners.
Purpose of the Study:
- To enhance practitioners' understanding of the physiology and presentations of acute and chronic CO poisoning in pregnancy.
- To provide comprehensive information on diagnostic approaches and treatment options for CO poisoning during pregnancy.
- To review historical case studies to illustrate diverse presentations and treatment strategies for CO poisoning in pregnant individuals.
Main Methods:
- A qualitative literature search was performed using PubMed and Google Scholar.
- Studies published between 1970 and 2014 focusing on CO poisoning during pregnancy were included.
- Exclusion criteria included non-English articles and studies involving nonhuman subjects.
Main Results:
- Nineteen published reports detailing cases of CO poisoning in pregnancy were identified.
- These reports spanned from 1971 to 2010, showcasing varied clinical presentations.
- The literature review highlighted diverse treatment methodologies employed over the years.
Conclusions:
- High clinical suspicion is essential for diagnosing carbon monoxide poisoning in pregnant patients.
- Diagnosis relies on history, physical evaluation, and environmental CO assessment; carboxyhemoglobin levels may not accurately reflect disease severity.
- Prompt oxygen therapy is recommended for all suspected cases, with hyperbaric oxygen therapy considered for significant maternal exposure. Fetal CO elimination requires longer treatment durations than in non-pregnant individuals, emphasizing the importance of patient education on prevention.
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