Abstract
A 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. The patient was hemodynamically stable but suffered from intense bouts of brown, sandy emesis for the first few hours. Investigation revealed the patient ingested 13.57 mg/kg of elemental iron. Due to the initial iron level, history and presentation time whole bowel irrigation was initiated with polyethylene glycol solution. Acute iron toxicity in pregnancy is a medical emergency that can result in multisystem organ failure leading to maternal death and potential fetal demise. 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. Initial treatment strategies may include whole bowel irrigation using polyethylene glycol electrolyte lavage solution and deferoxamine treatment along with necessary supportive care management. Despite concerns of teratogenicity deferoxamine does not cross the placenta and is regarded as safe for use during pregnancy. Maternal resuscitation must always be the primary objective in acute iron overdoses and, therefore such concern should not delay clinically indicated maternal treatment.
Highlights
A 22-year-old female was transferred from an outlying military hospital for an intentional multi-drug overdose
High maternal serum iron loads do not affect the developing fetus and are not associated with fetal malformations; advanced poisoning can lead to maternal death, spontaneous abortions or preterm emergency deliveries
Maternal resuscitation must always be the primary objective in acute iron overdoses and, such concern should not delay clinically indicated maternal treatment
Summary
A 22-year-old female was transferred from an outlying military hospital for an intentional multi-drug overdose. The patient was reportedly pregnant and had ingested a bottle of prenatal vitamins, some ondansetron (Zofran ) tablets along with alcohol. She presented to the military hospital a few hours after the ingestion. The patient experienced abdominal pain, diarrhea, and vomiting prior to her arrival and during her stay. Initial complete blood count and basic metabolic panel were unremarkable (See Table 1). 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. Intravenous fluids and supplemental oxygen were initiated. The patient was stable with normal vital signs; the hospital transfer was uneventful, minus intermittent episodes of vomiting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
