Ates Sinan, Karahan Mahmut Alp, Altay Nuray, Akelci Kazim, Ikiz Nagehan, Guzel Bulent, Ozer Mandeley Wilhelmina, Yilmaz Haci Durmus
Department of Obstetrics and Gynecology, Edirne Uzunkopru State Hospital, Edirne, Turkey.
Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Sanliurfa, Turkey.
Taiwan J Obstet Gynecol. 2018 Oct;57(5):692-695. doi: 10.1016/j.tjog.2018.08.014.
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.
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.
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.
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.
蝎子蜇伤在世界许多地区仍然是一个严重的健康问题。关于针对孕妇蝎子蜇伤所采用治疗方法对母亲和胎儿影响的信息非常有限。它们可导致诸如胎儿丢失、早产或胎盘异常等急性情况,还可引发其他可能对婴儿产生长期影响的情况。
本研究回顾性分析了2013年1月1日至2014年1月1日期间因蝎子蜇伤入住苏鲁克州立医院急诊室的24例孕妇的病历。评估了年龄、孕周、病例的月份分布、分娩类型、胎儿状况、受累身体部位以及局部和全身表现。使用阿布罗格分类法评估每个病例的临床严重程度。对孕周超过24周的孕妇进行了胎儿生物物理评分检查。新生儿在儿科每隔三个月接受12个月的精神和运动功能随访。
24例患者纳入研究,平均年龄26.1±2.4岁。蝎子蜇伤最常见的部位是下肢(58.3%)。病例中最常见的症状是立即出现局部疼痛(58%)。就孕周而言,41.6%的蝎子蜇伤发生在孕晚期。生物物理评分均为8分及以上。本研究中所有患者仅进行了对症治疗,未使用抗蛇毒血清。且未发生死亡或严重后遗症。
孕期蝎子蜇伤可能对胎儿和母亲没有显著不良影响。在仅有有限安全信息时,尤其是对于仅有局部症状的患者,应谨慎考虑对孕妇使用抗蛇毒血清的决策。