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Abstract
During pregnancy skeletal lead is mobilized by maternal bone turnover and can threaten fetal development. The exact strategy suggested to women of childbearing age, who were chronically exposed to lead, and, thus, have high bone lead burden, is not well established. We describe 4 years of follow-up of a 29-year-old woman with chronic lead intoxication. We (a) advised her to delay conception until ‘toxicological clearance’, (b) treated her with multiple courses of lead chelator, DMSA, and (c) prescribed oral calcium. Patient had low blood lead and protoporphyrin level during pregnancy until delivery. Delaying conception, lead chelation, and calcium supplementation can decrease fetal exposure.
Acknowledgements
The authors thank Janet Paquin and her staff at the U.S. Regional Environmental Protection Agency Laboratory for analyzing the Ayurvedic Medication for heavy metals. They also thank Michael Sirois and Steve Oliveira at the Harvard Metals Epidemiology Research group facility for the K-XRF bone lead estimates. The involvement of Dr. Hu and measurement of bone lead by K-X ray fluorescence was supported by NIEHS R01-07821 and NIEHS R01-05257.