RCOG World Congress 2025

Title : Snake bite during pregnancy: A rare and potentially life threatening complication

authors : Professor Shabnam Naz, Professor Tanweer Akhtar , Dr. Tanveer Ansari , Ayesha Haneef.

introduction

Snakebite during pregnancy is a rare but life-threatening emergency, with a reported 1% incidence in a large Indian hospital series (Sharma et al., 2006). (3)
In Pakistan, around 20,000 cases occur annually, with a mortality rate of 1.9 per 100,000 population, mainly affecting rural areas like Sindh province.
This case highlights a full-term envenomation, emphasizing the need for early recognition, multidisciplinary care, and careful antivenom use to improve maternal and fetal outcomes. (4)

objectives

report a rare case of snake bite in a pregnant woman at 37 weeks of gestation, highlighting the challenges in management and the importance of multidisciplinary approach.

case :

A 35-year-old pregnant woman (G3P2+0) presented to the emergency department with a history of snake bite (Lundi) on her Left lower extremity 12 hours prior to admission. She was in her 37 weeks of gestation and had no significant past medical or surgical history. On examination, she had two fang marks on her Left lower extremity with moderate swelling, redness and bleeding. A gravid uterus with a singe foetus, cephalic presentation with regular fetal heart sounds Her vitals were stable, but she had mild anaemia and dehydration.

managment

The patient was managed symptomatically with injection Augmentin transamine , vitamin K , and blood transfusions due to coagulopathy (INR 3.5), the patient required consultation with the gynaecology department for urgent delivery. She was induced with misoprostol and delivered a healthy baby via normal vaginal delivery. Post-delivery, the patient received antivenom (ASV) and showed significant improvement in her coagulation profil

discussion :

Snake bites in pregnancy are rare and pose significant challenges in management. A multidisciplinary approach involving obstetricians, physicians, and intensivists is essential for effective management in complex medical situations. (1)
The use of ASV in pregnancy is controversial, and this case demonstrates its safe use in a life- threatening situation. (2)

conclusion :

This case report emphasizes the need for prompt recognition and management of snake bites in pregnancy. A multidisciplinary approach and careful consideration of antivenom use can lead to favourable outcomes for both mother and foetus. Further research is needed to establish guidelines for the management of snake bites in pregnancy.

Refrences :

1-Sharma A, Pandey R, Bhardwaj M, Kumari S. Early intervention saved mother and baby in neurotoxic snake bite case. Indian J Anaesth. 2021;65(Suppl 3):S139–S140. https://pubmed.ncbi.nlm.nih.gov/34703059/
2-Wang, M. J., et al. (2019). Obstetric management of copperhead snake envenomation in pregnancy: A case report. Case Reports in Acute Medicine, 2(2), 35–41. https://karger.com/cra/article/2/2/35/74612

3-Singh, S., & Mohanty, R. R. (2020). Snakebite envenomation in pregnancy is rare, accounting for 0.4–1.0% of all snakebite envenomation's in India. Obstetric Medicine. Retrieved from https://www.researchgate.net/publication/44888116_Snakebite_During_Pregnancy_A_Literature_Review.

4-Khan, H., et al. (2014). Snakebite in Pakistan: A neglected public health problem. Journal of the Pakistan Medical Association, 64(12), 1410–1413. Daily News Dispatch. (2022). 20,000 snake bite cases registered every year in Pakistan. Retrieved from https://dnd.com.pk/health/20000- snake-bite-cases

RCOG World Congress 2025

Snake bite during pregnanyA rare and potentially life threatning complication

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