Fetal demise and maternal survival after diquat ingestion in a pregnant woman: a case report

• Published in: Toxicology communications 2024-12, Vol.8 (1)
• Main Authors: Fu, Rushen, Tang, Xu, Long, Zhenhong, Fang, Xuexue, Zhu, Xiaoxi, Chen, Yunchao
• Format: Article
• Language: English
• Subjects: case report; Central nervous system; Diquat; Emergency medical care; encephalopathy; fetal demise; Fetuses; Herbicides; Ingestion; Lavage; Mechanical ventilation; Multiple organ dysfunction syndrome; Poisoning; Poisons; Pregnancy; Renal failure; Stillbirth
• ISSN: 2473-4306; 2473-4306
• DOI: 10.1080/24734306.2024.2321431

Diquat is a nonselective bipyridylium herbicide and pre-harvest desiccant that is toxic to humans when ingested. However, the outcome of diquat poisoning during pregnancy has not been well described. A 32-year-old woman at 22 weeks of pregnancy was admitted to our emergency department after consuming 100 mL of diquat (200 g/L). She received emergency gastric lavage 1 h after consumption at an outside facility and was conscious with stable vital signs upon admission at our hospital. She experienced accidental abortion the following day, and the stillbirth was delivered in full. She quickly experienced multiple organ failure including kidney, liver, and central nervous system. She was then transferred to the intensive care unit and received tracheal intubation with mechanical ventilation, blood purification, toxin clearance, as well as other supporting therapies. The patient recovered after receiving treatment and was successfully discharged with no long-term sequela identified during the follow-up. Diquat has a large distribution of volume. Diquat poisoning produced stillbirth and multiple organ failure in a pregnant woman. Severe cases cause multiple organ failure. Reducing absorption, improving the excretion of poison, stabilizing organ function, and supporting care are the main treatments.