Vasculotoxic snakebite envenomation: Management challenges in pregnancy

Snakebite envenomation in pregnancy is rare. We report two cases of vasculotoxic snakebite in pregnancy and discuss the management challenges in pregnancy for successful maternal and perinatal outcomes. The first case was a 19-year-old woman who was eight weeks of gestation in her second pregnancy when she was bitten. She subsequently delivered by caesarean section at 33 weeks and 3 days because she developed eclampsia. The second case was a 24 year old woman in her third pregnancy, who was bitten at 29 weeks of gestation, who delivered vaginally at 36 weeks of gestation. Both were treated with multidisciplinary team approach including antisnake venom and antibiotics, along with fasciotomy for the second case. Both mothers recovered completely, without evidence of attributable fetal or neonatal morbidity. To conclude, antisnake venom, if indicated, and a multidisciplinary team approach plays an important role for successful maternal and perinatal outcomes in snakebite envenomation in pregnancy.