PARACETAMOL OVERDOSE IN PREGNANCY ANALYSIS OF THE OUTCOMES OF 300 CASES REFERRED TO THE TERATOLOGY INFORMATION-SERVICE

A prospective study was carried out to investigate the outcome of preg nancy in 300 women who had self-administered an overdose of paracetamo l, either alone, or as part of a combined preparation, Exposure occurr ed in all trimesters. The most striking feature of this study is that the majority of the pregnancies had normal outcomes, Over half of the mothers (160 = 53%) required treatment for the overdose, and 49 of the se had specific antidotes (33 mothers had acetylcysteine and 16 mother s had methionine), The rest of the mothers were given nonspecific trea tments including ipecacuanha (52), gastric lavage (42), and charcoal ( 16), None of the mothers died, There were 219 liveborn infants with no malformations, 61 of whom had been exposed in the first trimester, El even liveborn infants had malformations; none was exposed in the first trimester, One other infant exposed at 18 weeks had a diaphragmatic h ernia; this pregnancy was terminated at 22 weeks, In none of these 12 infants can the malformations be directly associated with paracetamol exposure, There were no apparent differences either in the sex ratio o r the body weights of term infants, There were seven full-term infants with neonatal problems that seem unrelated to paracetamol exposure, S ix premature infants also had neonatal problems, which were more likel y to be related to their degree of prematurity rather than paracetamol exposure, There was no obvious relationship between the time of expos ure and the time of delivery, The overall conclusion is that paracetam ol overdose per se is not an indication for termination of pregnancy. (C) 1997 Elsevier Science Inc.