Renal failure and neonatal death following snakebite during pregnancy: a case report

Abstract

ABSTRACT:A thirty-five-year-old Sudanese woman (gravida 4, para 3), at 34 weeks gestational age, presented with snakebite in her right leg. Examination of the cardiovascular, respiratory, gastrointestinal, and central nervous systems revealed no abnormalities. Her blood urea was 58 mg/dl; creatinine, 2.6 mg/dl; whole blood clotting time, 5:35 minutes. The patient was diagnosed as having acute renal failure and was then managed conservatively. She received polyvalent antivenom serum intravenously. On the next day, she delivered prematurely and the baby passed away due to respiratory distress. There was no postpartum bleeding and the patient's clotting time was 5:30 minutes. She was discharged from the hospital after 7 days when her clinical, biochemical and hematological parameters returned to normal values without dialysis.

Snakebite During Pregnancy: A Literature Review

“…Whereas some studies report the risk of poor fetal 12 5 Calloselasma rhodostoma NR 5 alive 1 aborted 4 alive Bhat 32 3 Viper 3 a 3 alive 3 aborted Fauveau 33 3 Species not reported NR 3 died 3 died Chugh 34 1 Viper NR Died Died Entman 15 1 35 1 Adder NR Alive Alive (premature) Sutherland 16 1 Pseudonaja sp. 37 1 Puff adder -Died Died 8 days after birth, unknown cause Lurie 28 1 Vipera palaestinae 1 Alive d Alive Otero 38 1 Bothrops asper 1 Alive Died (abruptio placentae) Duru 39 1 Vipera lebetina obtusa 1 Alive Alive Barry 30 9 Species not reported 9 9 alive 9 alive Sarkar 40 11 Viperidae 11 11 alive 10 alive, 1 fetal death (abruptio placentae in 3 cases including the death) Chen 41 3 Trimeresurus stejnegeri 2 3 alive 3 alive Nasu 42 1 Agkistrodon halys blomhoffi -Alive Fetal death Hanprasertpong 43 1 Calloselasma rhodostoma 1 Alive Fetal death (abruption placentae) Habib 44 11 10 Echis ocellatus 10 10 alive 1 fetal death 9 presumed alive 1 unknown (Naja) 1 Naja nigricollis NR Adam 45 1 Species not reported 1 Alive Fetal death (abruptio placentae) Adam 46 1 Species not reported 1 Alive Died 30 minutes after birth Chang 47 1 Agkistrodon contortrix -Alive Alive Kravitz 48 1 Agkistrodon contortrix 1 Alive Alive Sebe 49 3 2 Vipera lebetina obtusa 1 Vipera ammodytes meridionalis outcomes to be more common if envenomed in the first trimester, 4 this review found nearly the same number of fetal deaths occurred in pregnant females bitten in either the first or third trimesters. However, in many cases the gestational age was not reported, so it is not possible to state whether the length of gestation at time of envenomation is a risk factor.…”