Management of maternal Amanita phalloides poisoning during the first trimester of pregnancy: A case report and review of the literature

Background: Amanita phalloides poisoning produces acute liver failure and o ften death. Maternal poisonings are rare, and medical decisions of abortion or liver transplantation in this critical situation frequently are based o n laboratory data. We report here the case of a 22-year-old-woman in the 11 th week of pregnancy, who ingested mushrooms. Case Report: The patient's clinical symptoms (e.g., vomiting and diarrhea) and blood chemistry data (persistent increases of aspartate aminotransferas e and alanine aminotransferase and severe decreases in prothrombin, factor V, factor II, factor VII, and factor X) indicated poisoning of medium sever ity. The management consisted of intravenous hydration, and administration of silymarine and N-acetylcysteine. No fetal damage was observed, and birth and development of the infant (now 2 years of age) proceeded without incid ent. Conclusion: Abortion is not necessarily indicated in maternal poisoning by A. phalloides, even in the first trimester of pregnancy. (C) 2001 American Association for Clinical Chemistry.