TOXIC INGESTIONS IN PREGNANCY - ABORTIFACIENT USE IN A CASE SERIES OFPREGNANT OVERDOSE PATIENTS

Objectives: To profile young, pregnant patients with an overdose repor ted to an urban poison center; and to characterize the ingestions and short-term outcomes of these overdose patients. Methods: A prospective , observational study of female overdose patients was performed from N ovember 1, 1994, through March 31, 1995. Consecutive cases were identi fied from all calls to the regional poison center (annual call volume = 70,000) regarding intentional overdose in women between the ages of 12 and 30 years. Pregnancy tests were recommended by the poison center during the study period in female patients aged 12-30 years who prese nted to a health care facility (usually an urban ED) with an intention al overdose. Pregnant patients were then followed during their hospita lizations, and the results of toxicology studies and maternal and shor t-term fetal outcomes were recorded. Results: Pregnancy tests were obt ained for 371 (32%) of 1,142 eligible patients. Of patients with pregn ancy tests, 43 (11.6%) were pregnant. Although most cases were compara ble to general adult intentional ingestions, 5 of the 43 pregnant pati ents ingested known abortifacients. Most pregnant patients (35/43, 81% ) had toxicity at or below American Association of Poison Control. Cen ters (AAPCC) criteria for minimal toxicity, and all patients recovered completely. Conclusion: Pregnancy was a common finding in this sample of young, female, intentional overdose patients reported to our regio nal poison control center. Frequent use of abortifacients for toxic in gestions has not been previously reported. A pregnancy test should be obtained for all female patients of childbearing age with an intention al ingestion to address the potential association of the ingestion wit h an unanticipated or undesired pregnancy.