1
|
Schlein SM, Reno EM, Coffey CH, Casper LM, Klein DA, Claypool MS, Wiitala EL, Keyes LE. Environmental Exposures and Risks During Pregnancy. Wilderness Environ Med 2024:10806032241248626. [PMID: 38706212 DOI: 10.1177/10806032241248626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
The Women in Wilderness Medicine Research Committee of the Wilderness Medical Society conducted a narrative review to address considerations for pregnant individuals in wilderness environments. There is limited evidence behind many opinion-based recommendations on the safety of various environmental exposures in pregnancy. The authors reviewed the literature for the best available evidence, including observational studies, case series, limited controlled trials, and extrapolation from physiological data, as well as evaluating expert consensus statements. The benefits of exposure to natural environments include better pregnancy outcomes and improved maternal mental and physical health. Risks are similar to nonpregnant individuals with the added risks associated with maternal-fetal physiology in wilderness environments and difficulties of evacuation. This narrative review discusses pregnancy-specific concerns in extreme environments, including high altitude, hypothermia, hyperthermia, lightning strikes, envenomations, and common outdoor exposures.
Collapse
Affiliation(s)
- Sarah M Schlein
- Larner College of Medicine, University of Vermont, Burlington, VT
| | - Elaine M Reno
- Department of Emergency Medicine, University of Colorado, Aurora, CO
| | | | | | - David A Klein
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, CA
| | | | - Ellen L Wiitala
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, CO
| |
Collapse
|
2
|
Hedges K, Schaer M, Allen-Durrance A. Pit Viper Envenomation in Two Pregnant Bitches. J Am Anim Hosp Assoc 2024; 60:114-119. [PMID: 38662995 DOI: 10.5326/jaaha-ms-7377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 05/07/2024]
Abstract
Snake envenomation is relatively common in small animals, particularly in endemic areas. Effects and outcomes of envenomation during pregnancy are poorly described in humans and more so in veterinary patients. Two young pregnant female dogs presented to a university teaching hospital with a history of acute soft tissue swelling and bleeding. History, physical examination findings, and diagnostics were consistent with envenomation by crotalid snakes. Medical management of one of the dogs included administration of antivenin. Both dogs survived envenomation with minimal complications and went on to whelp without complications, and all fetuses survived. This is the first description of the management of pit viper envenomation in pregnant dogs.
Collapse
Affiliation(s)
- Katherine Hedges
- From College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Michael Schaer
- From College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | | |
Collapse
|
3
|
Wood D. Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review. Toxins (Basel) 2023; 15:675. [PMID: 38133179 PMCID: PMC10747621 DOI: 10.3390/toxins15120675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
Snakebite-related fatalities disproportionately affect populations in impoverished socio-economic regions, marked by limited access to adequate healthcare and constrained antivenom availability. Early medical intervention is pivotal in mitigating mortality and morbidity associated with snakebite envenoming (SBE). While clinical assessment remains fundamental in treating SBE, this review aims to spotlight objective parameters that could also affect outcomes. Selected studies that identify factors associated with poor outcomes are predominantly region-specific, single-site, and observational, yet collectively reveal similar findings. They consistently report factors such as treatment delays, susceptibility in vulnerable groups such as children and pregnant women, as well as various biochemical and haematological abnormalities. Acute kidney injury (AKI), low platelets, leucocytosis, abnormal coagulation, and elevated creatine kinase (CK) all show an association with poor outcomes. Furthermore, recognising rare and unusual SBE presentations such as adrenal insufficiency, severe hypertension, intracranial haemorrhage, acute angle closure glaucoma, and bowel ischaemia also has a bearing on outcomes. Despite the integration of these parameters into clinical decision tools and guidelines, the validation of this evidence is limited. This review underscores the imperative for high-quality, multi-centre studies aligned with consensus-driven Core Outcome Sets (COS) and Patient-Reported Outcome Measures (PROMS) to validate and strengthen the current evidence.
Collapse
Affiliation(s)
- Darryl Wood
- Department of Emergency Medicine, Blizzard Institute, Queen Mary University, London E1 2AT, UK;
- Queens Hospital, Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, London RM7 0AG, UK
| |
Collapse
|
4
|
Wium L. Neurotoxic snake bite in pregnancy. Obstet Med 2021; 14:187-189. [PMID: 34646349 PMCID: PMC8504299 DOI: 10.1177/1753495x211019236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/27/2021] [Indexed: 11/15/2022] Open
Abstract
Neurotoxic snake bites may cause paralysis within 1-8 h. Appropriate management includes early and adequate volumes of antivenom as well as ventilatory support. This case study describes the management of a pregnant woman who was bitten on a farm in rural South Africa and transferred to an academic hospital, 300 km away. An approach to the management of snake bites in pregnancy is discussed as well as a review of the current known literature of venomous snakes and the use of antivenom in pregnancy. This report aims to encourage further reporting of snake bites in pregnancy.
Collapse
|
5
|
Demirel MA, Alcigir ME, Ozkan O, Turkmen MB. The effects of antivenom administrations on the brain tissue of experimentally envenomed pregnant rats and their pups with Androctonus crassicauda scorpion venom during organogenesis period. Toxicon 2021; 200:13-18. [PMID: 34214578 DOI: 10.1016/j.toxicon.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 05/31/2021] [Accepted: 06/16/2021] [Indexed: 10/21/2022]
Abstract
This study aims to show the changing effects of Androctonus crassicauda venom and A. crasicauda specific antivenom during pregnancy in brain tissue of dams and their pups. Totally, 12 pregnant-Wistar Albino rats were randomly divided into two groups as venom-antivenom administration (n = 6) and control groups (n = 6). In venom-antivenom administration group (VAV), the sublethal dose of A. crassicauda venom dissolved in 1 mL physiological saline solution was subcutaneously (s.c.) injected into pregnant rats during organogenesis period (between 7 and 13 days of pregnancy). Four hours after each venom injection, 1 mL/s.c. dose of the specific anti-venom was administered to rats of VAV group. The rats in control group were given sterile saline solution 1 mL/s.c. In both groups, the fetuses were surgically delivered on the 21st day of pregnancy; dams and pups were sacrificed on postnatal 21 days, and their brain tissues were removed. The brain tissue of dams and their pups were evaluated histopathologically and immunohistochemically. To show the neuronal damages, 8-hydroxy-2-deoxyguanosine (8-OHDG) and amyloid beta precursor protein (ABPP) immunoexpressions were scored in cerebrum, cerebellum, pons and medulla oblongata of brain. To show the neuroprotection, reelin and beta-arrestin immunoexpressions were scored again in the same way. In this context, 8-OHDG immunoexpressions were increased in neocortex, hippocampus and nucleus accumbens when compared with that of control group. Amyloid beta precursor protein was negative in both groups. Reelin and beta-arrestin partly increased in fore and mid brain of VAV group as a reaction against neuronal damages when compared with that of control pups. The authors believe that prompt intervention using anti-venom to scorpion envenomation can partly stop neuronal damages. This neuroprotection may be increased to high and serial doses of anti-venom to save neonatal lives.
Collapse
Affiliation(s)
- Murside Ayse Demirel
- Laboratory Animals Care and Research Unit, Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Gazi University, 06330, Ankara, Turkey.
| | - Mehmet Eray Alcigir
- Department of Pathology, Faculty of Veterinary Medicine, Kirikkale University, 71450, Kirikkale, Turkey
| | - Ozcan Ozkan
- Department of Biology, Faculty of Science, Cankiri Karatekin University, 18100, Çankırı, Turkey
| | - Merve Biskin Turkmen
- Department of Pathology, Faculty of Veterinary Medicine, Kirikkale University, 71450, Kirikkale, Turkey
| |
Collapse
|
6
|
Vaucel JA, Gil-Jardine C, Labadie M, Larréché S, Paradis C, Nardon A, Courtois A, Langrand J, Kallel H. Epidemiology of scorpionism in France: nationwide scorpion exposure. Clin Toxicol (Phila) 2021; 59:888-895. [DOI: 10.1080/15563650.2021.1884692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Jules-Antoine Vaucel
- Centre Antipoison Nouvelle Aquitaine [Poison Control Centre of Nouvelle Aquitaine], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
- Service des Urgences Adulte [Emergency Department], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
| | - Cédric Gil-Jardine
- Service des Urgences Adulte [Emergency Department], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
| | - Magali Labadie
- Centre Antipoison Nouvelle Aquitaine [Poison Control Centre of Nouvelle Aquitaine], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
| | - Sébastien Larréché
- Département de Biologie Médicale [Medical Biology Department], Hôpital d'Instruction Des Armées Bégin, Saint-Mandé, France
| | - Camille Paradis
- Centre Antipoison Nouvelle Aquitaine [Poison Control Centre of Nouvelle Aquitaine], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
| | - Audrey Nardon
- Centre Antipoison Nouvelle Aquitaine [Poison Control Centre of Nouvelle Aquitaine], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
| | - Arnaud Courtois
- Centre Antipoison Nouvelle Aquitaine [Poison Control Centre of Nouvelle Aquitaine], Centre Hospitalier et Universitaire Bordeaux Pellegrin, Bordeaux, France
| | - Jérôme Langrand
- Centre Antipoison de Paris [Poison Control Centre of Paris], Hôpital Fernand-Widal, Paris, France
| | - Hatem Kallel
- Service de Réanimation [Intensive Care Unit], Centre Hospitalier de Cayenne, Cayenne, France
| |
Collapse
|
7
|
Ramirez-Cruz MP, Smolinske SC, Warrick BJ, Rayburn WF, Seifert SA. Envenomations during pregnancy reported to the national poison data system, 2009-2018. Toxicon 2020; 186:78-82. [PMID: 32771392 DOI: 10.1016/j.toxicon.2020.07.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Envenomations during pregnancy have consequences affecting both maternal and fetal outcomes. U.S. poison center data on envenomations offers a comparative view of envenomations in pregnant and non-pregnant women. The National Poison Data System of the American Association of Poison Control Centers was searched for cases of envenomation during pregnancy between January 1, 2009 and December 31, 2018 and compared with exposures to non-pregnant females of childbearing age. Odds ratios and descriptive statistics were used where appropriate. There were a total of 3,555 venomous animal exposures in pregnant women during this 10-year period, most commonly with scorpion stings. These were compared with 87,553 envenomations in non-pregnant women of childbearing age during that time period. Overall, drug treatment was administered in 350 (9.9%) cases of envenomation in pregnant women compared with 21,381 (24.4%) of non-pregnant patients. Antihistamines were less likely to be used in pregnant patients with scorpion (1.8% v. 9.2%), hymenoptera (bee, wasp, or hornet) (12.4% v. 37.1%), black widow spider (2.8% v. 8.1%), and caterpillar (10.4% v. 37.7%) exposures. There was an increased likelihood of antivenom use during pregnancy with rattlesnake envenomations (85.0% v. 58.9%) and black widow spider bites (4.8% v. 2.2%). There were no maternal deaths, and most maternal outcomes were coded as having no (1.0%) or minor (87.6%) effects. Three fetal deaths occurred, all following snakebites and all before 20 weeks gestation. Two were attributed as related, and one as of uncertain relationship to the exposure, by the managing poison centers. Most envenomations caused no or minor effects to pregnant women.
Collapse
Affiliation(s)
- M P Ramirez-Cruz
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - S C Smolinske
- New Mexico Poison Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - B J Warrick
- New Mexico Poison Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - W F Rayburn
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - S A Seifert
- New Mexico Poison Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
| |
Collapse
|
8
|
Abstract
Scorpion envenomation is common in the tropical and subtropical regions. It poses a major public health problem with some patients having serious clinical manifestations and severe complications including death. Old World and New World scorpions are usually contrasted because of differences in venom composition, clinical presentation and severity, and, accordingly, different therapeutic approaches. The majority of scorpion stings are either dry or result in low amounts of injected venom, thus explaining why up to 95% of scorpion stings ensue only in local signs. For a clinical envenomation to occur, it has been suggested that the interaction between the quantity of venom introduced in the body of the prey and the distribution volume should ensue in a critical threshold of scorpion toxin plasma concentration. In this case, there is a massive release of neurohormonal mediators (mainly catecholamine), with systemic vasoconstrictor effects eliciting a sharp increase in systemic arterial pressure and LV-filling pressure and decreased cardiac output. This early phase of cardiac dysfunction, also called "vascular phase", is followed by a severe cardiomyopathy, a form of Takotsubo cardiomyopathy, involving both ventricles and reversible in days to weeks. The more comprehensive understanding of the disease pathophysiology has allowed for a well-codified symptomatic treatment, thus contributing to a substantial reduction in the death toll of scorpion envenomation over the past few decades. The standard intensive-care treatment (when available) overcomes envenomation's consequences such as acute pulmonary edema and cardiogenic shock. Even though it continues to inspire many evaluative studies, immunotherapy seems less attractive because of the major role held by mediators in the pathogenesis of envenomation, and unfavorable pharmacokinetic properties to existing sera compared to venom. Meta-analyses of controlled trials of immunotherapy in severe scorpion envenomation reached similar conclusions: there is an acceptable level of evidence in favor of the use of scorpion antivenom (Fab'2) against Centruroides sp. in USA/Mexico, while there is still a need for a higher level of evidence for immunotherapy in the Old World envenomation.
Collapse
|
9
|
Yano J, Zerden M, German B. Presumed Copperhead Snakebite and Antivenom Administration in the Third Trimester. Wilderness Environ Med 2019; 30:446-449. [PMID: 31699647 DOI: 10.1016/j.wem.2019.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 06/14/2019] [Accepted: 06/21/2019] [Indexed: 10/25/2022]
Abstract
Snake envenomation during pregnancy is an uncommon emergency with several potential complications associated with the poisoning and its treatment. This case discusses a 27-y-old gravida 3, para 1102 (3 total pregnancies, 1 term birth, 1 premature birth, 0 abortions, 2 living births, twins) at 36 wk gestation who was bitten by a presumed Agkistrodon contortrix (copperhead snake). She had worsening pain and swelling in the right lower limb. Crotalidae polyvalent immune Fab was administered. The patient felt significantly better with improvement in swelling. She had a reactive nonstress test and reassuring coagulation studies. She gave birth to a healthy female infant 12 d later. This case supports the use of Crotalidae polyvalent immune Fab for venomous snakebites in pregnant patients to prevent possible maternal and fetal morbidity and mortality.
Collapse
Affiliation(s)
- Jessica Yano
- Family Medicine, WakeMed Health & Hospitals, Raleigh, NC.
| | - Matthew Zerden
- Family Medicine, WakeMed Health & Hospitals, Raleigh, NC
| | | |
Collapse
|
10
|
Wang M, Lu M, Ausbeck E, Harper L. Obstetric Management of Copperhead Snake Envenomation in Pregnancy: A Case Report. CASE REPORTS IN ACUTE MEDICINE 2019. [DOI: 10.1159/000501650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Snakebites in pregnancy can result in significant maternal and fetal harm; however, the literature to guide management of this rare obstetric complication remains limited. We describe our approach to envenomation in pregnancy based on the currently available evidence. A 27-year-old G2P1 female presented at 27 weeks’ gestation after suffering a copperhead snakebite. She received antivenom and antenatal steroids without adverse maternal or fetal event. Antenatal testing was reassuring throughout admission, and she was discharged home with plans for close outpatient surveillance. She later developed preterm premature rupture of membranes and preterm labor, with delivery of a live infant at 33 weeks’ gestation. The risk of adverse maternal and fetal outcomes following snake envenomation in pregnancy may warrant closer antenatal surveillance than has been previously described.
Collapse
|
11
|
Rattlesnake venom-induced recurrent coagulopathy in first trimester pregnant women – Two Cases. Toxicon 2019; 163:8-11. [DOI: 10.1016/j.toxicon.2019.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/23/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
|
12
|
Ates S, Karahan MA, Altay N, Akelci K, Ikiz N, Guzel B, Ozer MW, Yilmaz HD. Approach to scorpion stings in pregnancy: A retrospective case series and literature review. Taiwan J Obstet Gynecol 2019; 57:692-695. [PMID: 30342653 DOI: 10.1016/j.tjog.2018.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Scorpion stings remain a serious health problem in many parts of the world. There is very limited information regarding the effects of therapies delivered for scorpion stings in pregnant women on the mother and fetus. They can cause acute conditions such as fetal loss, preterm delivery, or placental abnormalities and can also result in other conditions that may have an effect on the baby in the long term. MATERIALS AND METHODS In this study the medical records of 24 pregnant women who were admitted to the emergency room at Suruç State Hospital due to scorpion stings between January 1, 2013 and January 1, 2014 were retrospectively reviewed. Age, gestational week, monthly distribution of the cases, type of delivery, status of the fetus, affected body sites, and local and systemic findings were evaluated. The clinical severity of each case was assessed using Abroug's classification. A fetal biophysical profile test was administered in pregnant women above 24 weeks of gestation. The newborns underwent follow-up for mental and motor functions in the pediatric department at three-month intervals for 12 months. RESULTS 24 patients, with a mean age of 26.1 ± 2.4 years, were included in the study. The most common region stung by scorpions was Lower extremity (58.3%). The most common symptom occurred in cases was immediate localized pain (58%). In terms of gestational age, 41.6% of scorpion sting were within the third trimester. Biophysical profile scores were 8 and above. Only symptomatic treatment, without use of anti-venom, was done to all the patients in this study. And neither death nor major sequel happened. CONCLUSION Scorpion stings during pregnancy may not have significant adverse effects on the fetus and the mother. Decisions regarding the use of anti-venom in pregnant women should be considered carefully when only limited safety information, especially in those patients with only local symptoms.
Collapse
Affiliation(s)
- Sinan Ates
- Department of Obstetrics and Gynecology, Edirne Uzunkopru State Hospital, Edirne, Turkey.
| | - Mahmut Alp Karahan
- Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Sanliurfa, Turkey.
| | - Nuray Altay
- Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Sanliurfa, Turkey.
| | - Kazim Akelci
- Department of Anesthesiology and Reanimation, Sanliurfa Suruc State Hospital, Sanliurfa, Turkey.
| | - Nagehan Ikiz
- Department of Obstetrics and Gynecology, Sanliurfa Suruc State Hospital, Sanliurfa, Turkey.
| | - Bulent Guzel
- Department of Pediatrics, Sanliurfa Suruc State Hospital, Sanliurfa, Turkey.
| | | | - Haci Durmus Yilmaz
- Department of Emergency, Tekırdag Sarkoy State Hospital, Tekirdag, Turkey.
| |
Collapse
|
13
|
Cnidarian Jellyfish: Ecological Aspects, Nematocyst Isolation, and Treatment Methods of Sting. Results Probl Cell Differ 2018; 65:477-513. [PMID: 30083932 DOI: 10.1007/978-3-319-92486-1_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cnidarians play an important role in ecosystem functioning, in the competition among species, and for possible utilization of several active compounds against cardiovascular, nervous, endocrine, immune, infective, and inflammatory disorders or having antitumoral properties, which have been extracted from these organisms. Nevertheless, notwithstanding these promising features, the main reason for which cnidarians are known is due to their venomousness as they have a serious impact on public health as well as in economy being able to affect some human activities. For this reason a preeminent subject of the research about cnidarians is the organization of proper systems and methods of care and treatment of stinging. This chapter aims to present the data about the morphological, ecological, toxicological, epidemiological, and therapeutic aspects regarding cnidarians with the purpose to summarize the existing knowledge and to stimulate future perspectives in the research on these organisms.
Collapse
|
14
|
Dorce ALC, Martins ADN, Dorce VAC, Nencioni ALA. Perinatal effects of scorpion venoms: maternal and offspring development. J Venom Anim Toxins Incl Trop Dis 2017. [PMID: 28630618 PMCID: PMC5471709 DOI: 10.1186/s40409-017-0121-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Scorpion envenomation is a public health problem, especially in tropical and subtropical countries. Considering the high incidence of scorpionism in some areas, pregnant women and nursing mothers may be possible victims. Scorpion stings alter the release of neurotransmitters and some cytokines. These mediators act as organizers and programmers in the adequate formation of the nerves, and non-physiological concentrations of them during the brain organization originate disorders and diseases that can appear later in the life of the individual. Despite the importance of this subject, there are only a few studies showing the effects of scorpion venom on maternal reproductive development, in the morphology and physical and behavioral development of offspring. The present review article summarizes the major findings on this issue. Biochemical changes in the blood – such as hyperglycemia, increase on the level of sodium and on the creatinine concentration – are observed after scorpion sting in humans and experimental animals. Some studies in the literature demonstrate that the scorpion venom affects the maternal reproductive development in humans and in experimental animals, increasing the frequency and amplitude of uterine contraction and the number of resorptions. The venom can also lead to some alterations in the embryonic or fetal development increasing the total weight of fetuses and of some organs. Moreover, it affects the general activity and locomotion during childhood and adulthood, and the anxiety level in adult females and males. It also alters the number of hippocampal neurons and interferes in the level of some cytokines. Altogether, it is evident that the venom, when administered during the pregnancy or lactation, affects the development of the offspring. Studies are being conducted to determine the actual participation of the venom in the development of the offspring, and to what extent they are detrimental to animal development.
Collapse
Affiliation(s)
- Ana Leticia Coronado Dorce
- Laboratory of Pharmacology, Butantan Institute, Av. Dr. Vital Brasil, 1500, São Paulo, SP CEP 05503-900 Brazil
| | - Adriana do Nascimento Martins
- Laboratory of Pharmacology, Butantan Institute, Av. Dr. Vital Brasil, 1500, São Paulo, SP CEP 05503-900 Brazil.,Graduate Program in Sciences - Toxinology, Butantan Institute, Av. Dr. Vital Brasil 1500, São Paulo, SP CEP 05503-900 Brazil
| | | | - Ana Leonor Abrahão Nencioni
- Laboratory of Pharmacology, Butantan Institute, Av. Dr. Vital Brasil, 1500, São Paulo, SP CEP 05503-900 Brazil
| |
Collapse
|
15
|
Ishikawa K, Ohsaka H, Omori K, Obinata M, Mishima K, Oode Y, Yanagawa Y. Pregnant Woman Bitten by a Japanese Mamushi (Gloydius blomhoffii). Intern Med 2015; 54:2517-20. [PMID: 26424315 DOI: 10.2169/internalmedicine.54.4708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report the fourth case of a pregnant woman bitten by a mamushi. A 33-year-old pregnant woman in the 25th week of gestation was bitten by a mamushi. Her vital signs were stable; however, biochemical analyses of the blood showed mild deterioration of anemia and hypoproteinemia. The effects of envenomation were limited to the extremities, the administration of supportive therapy without antivenom fortunately resulted in a favorable outcome. As there are differences in the maternal medical condition and weeks of gestation, further research is needed to clarify the optimal management strategy for administering antivenom in pregnancy.
Collapse
Affiliation(s)
- Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | | | | | | | | | | | | |
Collapse
|