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孕期蝎子蜇伤:对伊朗66例中毒的孕妇的结局分析

Scorpion stings in pregnancy: an analysis of outcomes in 66 envenomed pregnant patients in Iran.

作者信息

Najafian Mahin, Ghorbani Ahmad, Zargar Mahvash, Baradaran Masoumeh, Baradaran Nafiseh

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Venom Anim Toxins Incl Trop Dis. 2020 Apr 30;26:e20190039. doi: 10.1590/1678-9199-JVATITD-2019-0039.

Abstract

BACKGROUND

Scorpionism is one of the most important health problems in tropical regions, which unfortunately results in thousands of deaths annually. Pregnant women are potential victims in areas with high scorpion-sting prevalence. Limited medical data are available on the effects of scorpion envenomation in pregnant women. This study aimed to examine the effect of scorpion envenomation on pregnancy outcomes in 66 cases.

METHODS

The present descriptive/analytical cross-sectional study was performed on 66 scorpion-envenomed pregnant women referred to the clinical toxicology unit of Ahvaz Razi Hospital in Iran during 2015-2017. The variables assessed in all cases, via questionnaire and hospital medical records, were: age, patient residency, gestational week, status of the fetus, laboratory anomalies, clinical severity of envenomation, sting site and scorpion species. Pregnancy outcome (miscarriage, stillbirth, preterm birth, normal delivery) and status of the newborns were also evaluated. Data were analyzed using SPSS software (version 24.0).

RESULTS

The following pregnancy outcomes were recorded from envenomed pregnant women: miscarriage = 1.5% (n = 1), stillbirth = 4.5% (n = 3), preterm birth = 10.6% (n = 7), normal birth = 83% (n = 55). Among participants whose pregnancy led to birth, 11(17.7%) cases had prenatal-neonatal complications. Neonatal complications, including Apgar score less than 8 points at 5 min, were found in 7 (11.3%) preterm birth cases and in 4 (6.4%) normal birth cases, along with birth weight below 2500 g in normal births. A significant relationship was found between adverse pregnancy outcomes and bite location, as well as scorpion species, but no relationship was found with other variables.

CONCLUSION

Envenomation significantly contributes to preterm birth. Moreover, the location of bites and the type of scorpion species have a decisive role in the pregnancy outcome of scorpion-envenomed pregnant women.

摘要

背景

蝎蜇伤是热带地区最重要的健康问题之一,每年不幸导致数千人死亡。在蝎蜇伤高发地区,孕妇是潜在的受害者。关于蝎毒对孕妇影响的医学数据有限。本研究旨在调查66例蝎蜇伤孕妇的妊娠结局。

方法

本描述性/分析性横断面研究对2015年至2017年期间转诊至伊朗阿瓦士拉齐医院临床毒理学科的66例蝎蜇伤孕妇进行。通过问卷调查和医院病历对所有病例评估的变量包括:年龄、患者居住地、孕周、胎儿状况、实验室异常、蜇伤临床严重程度、蜇伤部位和蝎子种类。还评估了妊娠结局(流产、死产、早产、正常分娩)和新生儿状况。使用SPSS软件(版本24.0)进行数据分析。

结果

记录了蝎蜇伤孕妇的以下妊娠结局:流产=1.5%(n = 1),死产=4.5%(n = 3),早产=10.6%(n = 7),正常分娩=83%(n = 55)。在妊娠导致分娩的参与者中,11例(17.7%)有产前-新生儿并发症。在7例(11.3%)早产病例和4例(6.4%)正常分娩病例中发现了新生儿并发症,包括5分钟时阿氏评分低于第8分,以及正常分娩中出生体重低于2500克。发现不良妊娠结局与蜇伤部位以及蝎子种类之间存在显著关系,但与其他变量无关。

结论

蝎毒显著导致早产。此外,蜇伤部位和蝎子种类对蝎蜇伤孕妇的妊娠结局起决定性作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4bb/7204829/9f1d61f4b819/1678-9199-jvatitd-26-e20190039-va1.jpg

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