Upon transfer the patient was interviewed and labs were drawn. The patient was stable with normal vital signs the hospital transfer was uneventful, minus intermittent episodes of vomiting. Intravenous fluids and supplemental oxygen were initiated. The military hospital did not have the ability to perform serum iron studies and was concerned about iron toxicity secondary to excessive prenatal vitamin ingestion.
Initial complete blood count and basic metabolic panel were unremarkable (See Table 1). The patient’s vomitous was described as tan, sandy and thick in consistency. Per the transferring facility, the patient experienced abdominal pain, diarrhea, and vomiting prior to her arrival and during her stay. She presented to the military hospital a few hours after the ingestion. The patient was reportedly pregnant and had ingested a bottle of prenatal vitamins, some ondansetron (Zofran ®) tablets along with alcohol. Maternal resuscitation must always be the primary objective in acute iron overdoses and, therefore such concern should not delay clinically indicated maternal treatment.Ī 22-year-old female was transferred from an outlying military hospital for an intentional multi-drug overdose. Despite concerns of teratogenicity deferoxamine does not cross the placenta and is regarded as safe for use during pregnancy. Initial treatment strategies may include whole bowel irrigation using polyethylene glycol electrolyte lavage solution and deferoxamine treatment along with necessary supportive care management. High maternal serum iron loads do not affect the developing fetus and are not associated with fetal malformations however advanced poisoning can lead to maternal death, spontaneous abortions or preterm emergency deliveries. Acute iron toxicity in pregnancy is a medical emergency that can result in multisystem organ failure leading to maternal death and potential fetal demise.
Due to the initial iron level, history and presentation time whole bowel irrigation was initiated with polyethylene glycol solution. Investigation revealed the patient ingested 13.57 mg/kg of elemental iron. The patient was hemodynamically stable but suffered from intense bouts of brown, sandy emesis for the first few hours.
Keywords: Iron Overdose Pregnancy Whole Bowel Irrigation DeferoxamineĪ 22-year-old pregnant female was transferred to the emergency department having ingested a bottle of iron-containing prenatal vitamins, ondansetron (Zofran ®) tablets and alcohol. 1Baptist Medical Center Downtown, Emergency Department, Jacksonville, Florida, USA 2Mayo Clinic, Department of Pharmacy, Jacksonville, Florida, USA.Įmail: September 20 th, 2012 revised October 24 th, 2102 accepted November 15 th, 2012
0 kommentar(er)
