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CC BY-NC-ND 4.0 · AJP Rep 2022; 12(01): e113-e116
DOI: 10.1055/s-0042-1744216
Case Report

Perinatal Carbon Monoxide Poisoning: Treatment of a 2-Hour-Old Neonate with Hyperbaric Oxygen

Allyson A. Kreshak
1   Division of Medical Toxicology, Department of Emergency Medicine, University of California San Diego, San Diego, California
,
Shelley M. Lawrence
2   Division of Neonatal-Perinatal Medicine, University of Utah, Intermountain Health Care, Salt Lake City, Utah
,
Sam T. Ontiveros
3   Department of Emergency Medicine, Medical University of South Carolina, Charleston, South Carolina
,
Tiffany Castellano
4   Division of Hyperbaric and Undersea Medicine, Department of Emergency Medicine, University of California San Diego, San Diego, California
,
Karen B. VanHoesen
4   Division of Hyperbaric and Undersea Medicine, Department of Emergency Medicine, University of California San Diego, San Diego, California
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Abstract

A 41-year-old gravida 4 para 3 (G4P3) and 385/7 weeks pregnant woman presented to labor and delivery with dizziness, headache, and decreased fetal movement after 12 hours of exposure to carbon monoxide (CO) from a grill that was used inside for heat. The mother was hemodynamically stable, and her neurologic examination was intact. Her carboxyhemoglobin level, which was obtained 12 hours after removal from the CO exposure, was 7.4%. The fetus's heart rate was 173 beats per minute with moderate variability and one late appearing deceleration, not associated with contractions. The biophysical profile score was 2 of 8. The obstetrics team performed a routine cesarean section. The 1- and 5-minute Apgar's scores were 7 and 8, respectively. The arterial cord gas result was as follows: pH = 7.05, PCO2 = 71 mm Hg, pO2 = 19 mm Hg, bicarbonate = 14 mmol/L, and carboxyhemoglobin = 11.9%. The mother and infant were treated with hyperbaric oxygen therapy consisting of 100% oxygen at 2.4 atmosphere absolutes (ATA) for 90 minutes at 2.5 hours after delivery. Following one hyperbaric oxygen treatment, the infant was transitioned to room air and routine postpartum treatment and was discharged 3 days later in good condition. Hyperbaric oxygen treatment was well tolerated in this neonate.

Keywords

perinatal - carbon monoxide - poisoning - hyperbaric oxygen - pregnancy


Publication History

Received: 05 November 2021

Accepted: 02 January 2022

Article published online:
09 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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