Abstract
Modalities of oxygen therapy for pregnant women intoxicated with carbon monoxide (CO) are ill defined. Hyperbaric oxygen (HBO) is presumed to be hazardous to the pregnancy. On the other hand CO entails anoxic injuries in the mother and fetus. We have entered 44 pregnant women who sustained an acute carbon monoxide poisoning at home, into a prospective study in order to assess HBO tolerance. They were treated within 5.3±3.7 h (range: 1–12) of the intoxication with a combination of 2 h of HBO at a pressure of 2 atmospheres absolute (ATA) and 4 h of normobaric oxygen, irrespective of the clinical severity of the intoxication and of the age of pregnancy. Six patients were lost to obstetric follow-up. Only 2 patients sustained a spontaneous abortion: 1 within 12 h and 1 within 15 days of the intoxication. Thirty-four women gave birth to normal newborns. Finally 1 elected to undergo abortion for reasons unrelated to the intoxication and 1 gave birth to a baby with Down's syndrome. There is no evidence that HBO was involved with either abortion of our study. We conclude that HBO may be carried out in pregnant women acutely intoxicated with carbon monoxide.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barral-Chamaillard C, Foucherot-Hornez T, Allerat G (1978) Encéphalopathie chez l'enfant après intoxication oxycarbonée de la mère au 7e mois de grossesse. Bull Med Legale Toxicol 21:103–107
Beaudoing A, Gachon J, Butin LP, Bosr M (1969) Les conséquences foetales de l'intoxication oxycarbonée de la mère. Pédiatrie 24:539–553
Copel JA, Bowen F, Bolognese RJ (1982) Carbon monoxide intoxication in early pregnancy. Obstet Gynecol 59 [Suppl]:26–28
Cramer CR (1982) Fetal death due to accidental meternal carbon monoxide poisoning. J Toxicol Clin 19:297–301
Fechter LD, Annau Z (1977) Toxicity of mild prenatal carbon monoxide exposure. Science 197:680–682
Ginsberg MD, Myers RE (1976) Fetal brain injury after maternal carbon monoxide intoxication. Neurology 26:15–23
Goldstein DP (1965) Carbon monoxide poisoning in pregnancy. Am J Obstet Gynecol 92:526–528
Grosbuis S, Estournet B, Barois A (1978) L'intoxication oxycarbonée chez l'enfant. Journées Parisiennes de Pédiatrie. Flammarion, Paris, pp 495–515
Muller GL, Graham S (1955) Intrauterine death of the fetus due to accidental carbon monoxide poisoning. N Engl J Med 252:1075–1078
Piédelièvre Ch, Le Breton R, Dérobert L (1969) Intoxication par l'oxyde de carbone et passage du toxique au travers du filtre placentaire. Med Leg et Dom Corp 2:389–392
Turpin JC, Escourolle R, Gray F, Fournet JP, Castaing H, Dupart MC (1978) Intoxication oxycarbonée chez le foetus. A propos d'une observation anatomoclinique. Rev Neurol 134:485–495
Effects of diving in pregnancy (1987) In: Proceedings of 19th. Underseas Medical Society Workshops. Bethesda, Md, p 17
(1978) Hyperbaric oxygenation in obstetrics and neonatalogy. In: Fischer B, Jain KK, Braun E, Lehrl S (eds) Handbook of hyperbaric oxygen therapy. Springer, Berlin Heidelberg New York, pp 215–218
Grote W, Wagner WD (1973) Malformations in rabbit embryos after hyperbaric oxygenation. Klin Wochenschr 51:248–250
Raphael JC, Elkharrat D, Jars-Guincestre MC, Chastang Cl, Chasles V, Vercken JB, Gajdos Ph (1989) Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet II:414–418
Brix KA (1982) Environmental and occupational hazards to the fetus. J Reprod Med 27:577–583
Hollander DI, Nagey DA, Welch R, Rupkin M (1987) Hyperbaric oxygen therapy for the treatment of acute carbon monoxide poisoning in pregnancy. A case report. J Reprod Med 32:615–617
Astrup P, Trolle D, Olsen HM, Kjeldsen K (1972) Effect of moderate carbon-monoxide exposure on fetal development. Lancet II:1220–1222
Longo LD (1976) Carbon monoxide: effects on oxygenation of the fetus in utero. Science 194:523–525
Nicloux M (1913) Mécanisme du passage de l'oxyde de carbone de la mère au foetus et des respirations placentaire et tissulaire. Arch Obstet Gynecol 3:42–51
Longo LD (1977) The biological effects of carbon monoxide on the pregnant woman, fetus and newborn infant. Am J Obstet Gynecol 129:69–103
Hill EP, Hill JR, Power GG, Longo LD (1977) Carbon monoxide exchanges betwen the human fetus and mother: a mathematical model. Am J Physiol 232:311–323
Gabb G, Robin ED (1987) Hyperbaric oxygen. A therapy in search of diseases. Chest 92:1074–1082
Feldmeier JJ, Workman WT (1983) The USAF hyperbaric center: a look through the porthole. Milit Med 148:118–121
Myers RAM, Snyder SK, Linberg S, Cowley RA (1981) Value of hyperbaric oxygen in suspected carbon monoxide poisoning. JAMA 246:2478–2480
(1987) Oxygen toxicity. In: Fischer B, Jain KK, Braun E, Lehrl S (eds) Handbook of hyperbaric oxygen therapy. Springer, Berlin Heidelberg New York, 35–46
Bureau MA, Shapcott D, Berthiaume Y, Monette J, Blouin D, Blanchard P, Begin R (1983) Maternal cigarette smoking and fetal oxygen transport: a study of P50, 2.3-diphosphoglycerate, total hemoglobin, hematocrit, and type F hemoglobin in fetal blood. Pediatrics 72:22–26
Giraud JR, Tournaire M (1981) Pathologie de la grossesse. In: Surveillance et thérapeutique obstétricale. Masson, Paris, pp 119–127
Leridon H (1987) La mortalité spontanée. Rôle de l'âge de la mère, de la parité et des antécédents d'avortement. J Gynécol Obstet Biol Reprod 16.4:425–431
Wilcox AJ, Weinberg CR, O'Connor JF, Baird DD, Schlatterer JP, Canfield RE, Armstrong EG, Nisula BC (1988) Incidence of early loss of pregnancy. N Engl J Med 319:189–194
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Elkharrat, D., Raphael, J.C., Korach, J.M. et al. Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy. Intensive Care Med 17, 289–292 (1991). https://doi.org/10.1007/BF01713940
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01713940