Gupta Ashwini, Bhandari Sudeep, Anand Ayush, Sharma Sanjib Kumar, Gautam Arun, Priyanka K C, Acharya Neeraj, Singh Sweta
B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Oxf Med Case Reports. 2022 Oct 22;2022(10):omac105. doi: 10.1093/omcr/omac105. eCollection 2022 Oct.
We reported a case of snakebite in an 18-year-old woman, Gravida 2 Para 1+0 in the third trimester of pregnancy who presented with pain and swelling over the left hand and forearm and vaginal spotting. The laboratory investigations revealed coagulopathy attributed to green pit viper envenomation. On the fourth day of admission, the patient developed sudden abdominal pain and massive per vaginal bleeding with haemorrhagic shock, most likely abruptio placentae. In Nepal, no anti-snake venom has been developed for green pit-viper. So, she was managed conservatively, including blood transfusion, and delivered a single live female baby without any foetal complications. The patient was discharged along with the baby after 8 days of hospitalization. This case demonstrated that vigilant observation and appropriate resuscitation with fluids and blood products could save mother and baby in pit viper envenomation cases in settings where specific anti-snake venom is unavailable.
我们报告了一例18岁女性蛇咬伤病例，该女性为孕2产1+0，处于妊娠晚期，表现为左手和前臂疼痛、肿胀以及阴道点滴出血。实验室检查显示凝血功能障碍，归因于竹叶青蛇咬伤中毒。入院第四天，患者突然出现腹痛和大量阴道出血并伴有失血性休克，很可能是胎盘早剥。在尼泊尔，尚未研发出针对竹叶青蛇的抗蛇毒血清。因此，对她进行了保守治疗，包括输血，她顺利产下一名存活女婴，未出现任何胎儿并发症。住院8天后，患者与婴儿一同出院。该病例表明，在没有特定抗蛇毒血清的情况下，对竹叶青蛇咬伤中毒病例进行密切观察并适当输注液体和血液制品可挽救母婴生命。
