Barhoumi Mohamed Hafed, Bannour Badra, Barhoumi Tarek, Jouini Rami, Marwene Nadia, Fatnassi Mohamed Ridha
Service d'Anesthésie et de Réanimation CHU Ibn El Jazzar Kairouan, Tunisie.
Service de Gynécologie et d'Obstétrique CHU Ibn El Jazzar Kairouan, Tunisie.
Pan Afr Med J. 2016 Dec 7;25:227. doi: 10.11604/pamj.2016.25.227.11041. eCollection 2016.
Acute organophosphorus pesticides (OPs) poisoning during pregnancy are rare events, not well documented in the literature. We conducted a retrospective analysis of outcomes in seven cases of suicidal ingestion of OP in pregnant women. This intoxication was most often serious. Indeed, five of seven parturients had an initial Glasgow score < 9 and the POP score was ≥ 3 in all parturients. Five patients required mechanical ventilation for a mean duration of 3,4 days. All patients reported favorable outcomes but in more than half of the cases fetuses had unfavorable outcomes (fetal death in utero). Two mechanisms can explain these fetal complications. The first mechanism is fetal hypoxia, associated or not with a state of shock, which can be reflected in the Fetal Heart Rate (FHR) by tachycardia or decelerations and result in intrauterine fetal death. The second mechanism is the passage of these pesticides through the placental barrier representing a potential risk to the fetus due to the alteration of the microsomal enzyme systems.
孕期急性有机磷农药(OPs)中毒较为罕见,文献中对此记载不多。我们对7例孕妇自杀性摄入有机磷农药的结局进行了回顾性分析。这种中毒情况通常较为严重。实际上,7名产妇中有5名初始格拉斯哥评分<9分,所有产妇的农药中毒评分均≥3分。5名患者需要机械通气,平均持续时间为3.4天。所有患者报告预后良好,但超过半数病例中的胎儿预后不佳(宫内胎儿死亡)。有两种机制可以解释这些胎儿并发症。第一种机制是胎儿缺氧,无论是否伴有休克状态,这可通过胎儿心率(FHR)的心动过速或减速反映出来,并导致宫内胎儿死亡。第二种机制是这些农药通过胎盘屏障,由于微粒体酶系统的改变,对胎儿构成潜在风险。