Jia Yanxi, Zhan Yongchi, Huang Guiqiong, Deng Chunyan, Yu Haiyan
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Front Pharmacol. 2024 Nov 27;15:1502596. doi: 10.3389/fphar.2024.1502596. eCollection 2024.
Brodifacoum is a highly potent superwarfarin rodenticide that leads to coagulopathy. Although the effect of warfarin during pregnancy is well understood, reports on superwarfarin poisoning, like brodifacoum, during pregnancy are scarce.
We report a case involving a woman with a singleton pregnancy who experienced sudden nasal hemorrhage accompanied by hematuria at 34 weeks and 3 days of gestation, with no apparent etiology. It was ultimately diagnosed as acquired coagulopathy resulting from brodifacoum poisoning. Fetal ultrasonography revealed significant intracranial hemorrhage, leading to intrauterine fetal demise and subsequent pregnancy termination. Following the correction of the patient's coagulation profile through intravenous and oral administration of vitamin K1, tailored to the serum levels of brodifacoum, diligent monitoring confirmed that the patient was in stable condition.
The primary hazard associated with the ingestion of brodifacoum is hemorrhage, with clinical presentations varying from asymptomatic cases to overt bleeding, which may present as hematuria, epistaxis, menometrorrhagia, and intracranial hemorrhage. Therefore, the diagnosis and management of this type of poisoning pose significant challenges. Prompt recognition and ongoing care for pregnant individuals affected by rodenticide toxicity are crucial for optimizing maternal health outcomes.
溴敌隆是一种高效的超级华法林灭鼠剂，可导致凝血病。虽然华法林在孕期的影响已为人熟知，但关于孕期溴敌隆等超级华法林中毒的报道却很稀少。
我们报告一例病例，一名单胎妊娠女性在妊娠34周零3天时突然出现鼻出血并伴有血尿，病因不明。最终诊断为溴敌隆中毒所致的获得性凝血病。胎儿超声检查显示有大量颅内出血，导致宫内胎儿死亡，随后终止妊娠。根据血清溴敌隆水平，通过静脉和口服维生素K1纠正患者的凝血状况后，经过密切监测确认患者病情稳定。
摄入溴敌隆的主要危害是出血，临床表现从无症状到明显出血不等，可能表现为血尿、鼻出血、月经过多和颅内出血。因此，此类中毒的诊断和处理极具挑战性。对于受灭鼠剂毒性影响的孕妇，及时识别并持续护理对于优化孕产妇健康结局至关重要。
