Mother and Fetus Both Survive from Severe Paraquat Intoxication

Abstract

Paraquat, 1,1′-dimethyl-4,4′-bipyridylium dichloride, is a commonly applied bipyridyl contact herbicide. Paraquat poisoning from suicidal ingestion causes high mortality rates, and severe poisoning has been uniformly fatal in pregnant females (nine of nine cases). We presented a case of severe paraquat poisoning from suicidal ingestion in a woman in the third trimester of pregnancy (G5P4A1). Urine dithionate test was strongly positive (showed dark blue color). She was managed with charcoal hemoperfusion × 2, megadose of cyclophosphamide, and methylprednisolone pulse therapy. Despite initial deterioration of renal and liver function, she had a normal spontaneous delivery of a healthy girl baby 14 weeks after the exposure. The child reached developmental milestones normally and appeared healthy and well nourished at age 5. This may be the first documentation of a pregnant woman with moderate to severe paraquat poisoning successfully delivering a healthy baby.

Keywords :

• Paraquat
• Pregnancy
• Management
• Survival
• Cyclophosphamide
• Methylprednisolone
• Hemoperfusion