[Ten practical issues concerning acute poisoning with carbon monoxide in pregnant women]

Abstract

Background: The poisoning of carbon monoxide (CO) is the leading cause of death by poisoning in France. Its consequences are potentially serious to the fetus. Literature is ancient and little known.

Purpose and method: Make an inventory of knowledge about carbon monoxide poisoning during pregnancy.

Result: The CO causes maternal then fetal tissue hypoxia primarily by binding to hemoglobin with which it has a high affinity. Its transplacental passage may cause fetal harm, predominantly in the brain. Severity seems correlated with maternal symptoms during exposure. In the absence of maternal symptoms, however, the available data are reassuring. Hyperbaric oxygen therapy may reduce the risk to the fetus.

Discussion: Oxygen therapy should be offered in all cases of CO poisoning, especially if there are maternal symptoms during exposure. In addition, a fetal echography directed on the cephalic pole - even a fetal magnetic resonance imaging three weeks after exposure - should also be proposed.

Keywords: Acute poisoning; Carbon monoxide; Fetal damage; Grossesse; Intoxication aiguë; Lésions fœtales; Monoxyde de carbone; Pregnancy.