Carbon Monoxide Exposure During Pregnancy.

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  • Additional Information
    • Source:
      Publisher: Williams and Wilkins Country of Publication: United States NLM ID: 0401007 Publication Model: Print Cited Medium: Internet ISSN: 1533-9866 (Electronic) Linking ISSN: 00297828 NLM ISO Abbreviation: Obstet Gynecol Surv Subsets: MEDLINE
    • Publication Information:
      Original Publication: Baltimore, MD : Williams and Wilkins
    • Subject Terms:
      Carbon Monoxide/*analysis ; Carbon Monoxide Poisoning/*diagnosis ; Maternal Exposure/*adverse effects ; Oxygen Inhalation Therapy/*methods ; Pregnancy Complications/*chemically induced; Carbon Monoxide Poisoning/complications ; Carbon Monoxide Poisoning/therapy ; Female ; Fetal Hypoxia/etiology ; Fetal Hypoxia/therapy ; Fetus/drug effects ; Humans ; Hyperbaric Oxygenation ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/therapy ; Time Factors ; United States
    • Abstract:
      Importance: Carbon monoxide (CO) is the leading cause of poisoning in the United States and is associated with high maternal and fetal mortality rates. Given the nonspecific signs and symptoms of toxicity, cases may go unsuspected or attributed to other etiologies. As CO adversely affects both mother and fetus, it is important for practitioners to recognize and treat poisoning in a timely manner.
      Objective: We seek to assist practitioners with understanding the physiology and recognizing the presentations of both acute and chronic CO poisoning, as well as provide information on diagnosis and treatment options. We also conducted a review of cases described in the literature during the past half century to show varying presentations and treatment methodologies.
      Evidence Acquisition: A qualitative literature search was conducted using PubMed and Google Scholar for articles published between 1970 and 2014 that assessed cases of CO poisoning during pregnancy. Excluded studies were not in English or contained nonhuman subjects.
      Results: Nineteen published reports of CO poisoning during pregnancy described in varying levels of detail were found in the literature from 1971 to 2010.
      Conclusions and Relevance: Carbon monoxide poisoning requires a high degree of suspicion. Diagnosis is made based on initial history and physical evaluation and assessment of environmental CO levels; presenting carboxyhemoglobin levels may be poor indicators of severity of disease. Oxygen therapy should be initiated promptly in all possible cases with consideration of hyperbaric oxygen therapy in cases of significant maternal exposure. Treatment requires a longer duration for fetal CO elimination than in the nonpregnant patients. Importantly, practitioners should educate pregnant patients on prevention.
    • Accession Number:
      7U1EE4V452 (Carbon Monoxide)
    • Publication Date:
      Date Created: 20151121 Date Completed: 20160908 Latest Revision: 20151120
    • Publication Date:
      20221213
    • Accession Number:
      10.1097/OGX.0000000000000238
    • Accession Number:
      26584719