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A Case Report and Literature Review

Karen B. Van Hoesen, MD; Enrico M. Camporesi, MD; Richard E. Moon, MD; Marvin L. Hage, MD; Claude A. Piantadosi, MD

JAMA. 1989;261(7):1039-1043.

Abstract
Carbon monoxide (CO) is the leading cause of death due to poisoning. Although uncommon, CO poisoning does occur during pregnancy and can result in fetal mortality and neurological malformations in fetuses who survive to term. Uncertainty arises regarding the use of hyperbaric oxygen (HBO) as a treatment for the pregnant patient because of possible adverse effects on the fetus that could be induced by oxygen at high partial pressures. While the dangers of hyperoxia to the fetus have been demonstrated in animal models, careful review of animal studies and human clinical experience indicates that the short duration of hyperoxic exposure attained during HBO therapy for CO poisoning can be tolerated by the fetus in all stages of pregnancy and reduces the risk of death or deformity to the mother and fetus. A case is presented of acute CO poisoning during pregnancy that was successfully treated with HBO. Recommendations are suggested for the use of HBO during pregnancy.

(JAMA 1989;261:1039-1043)

Author Affiliations
From the Departments of Anesthesiology, Hyperbaric Center (Drs Van Hoesen, Camporesi, and Moon), Medicine, Division of Pulmonary Medicine (Drs Moon and Piantadosi), and Obstetrics and Gynecology (Dr Hage), Duke University Medical Center, Durham, NC.

Footnotes
Reprint requests to the Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710 (Dr Camporesi).

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