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Environmental Medicine Integrating a Missing Element into Medical Education (1995) / Chapter Skim
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Case Study 7: Fetal Death Due to Nonlethal Maternal Carbon Monoxide Poisoning
Pages 244-248

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From page 244...
... concentrations of both the mother and the fetus I We present the circumstances of another fetal death due to a nonlethal maternal CO poisoning in which COHb levels were obtained for both mother and fetus.
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From page 245...
... The initial chest radiograph was interpreted as showing bilateral alveolar infiltrates consistent with the adult respiratory distress syndrome. On the second hospital day, the patient went into labor spontaneously and delivered a 1050-g stillborn female fetus of approximately 7 months gestation, with a crown-heel length of 39 cm and crown-rump length of 27 cm.
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From page 246...
... Investigations of CO exchange between mother and fetus have shown that CO absorption and elimination occur more slowly in the fetal circulation [11,121. Following maternal exposure to CO, the fetal COHb rises more slowly than the maternal COHb but will continue to rise for several hours after acute exposure until it eventually reaches an equilibrium at a level which is approximately 10% greater than the mother's COHb saturation [12~.
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From page 247...
... The authors hope that this account of fetal death associated with nonfatal maternal exposure to CO, which is only the secured report to include measurement of both maternal and fetal COHb saturations, will alert both death investigators and clinicians to the fragile relationship that exists between mother and fetus under circumstances of CO exposure. Addendum Since the completion of this report, an additional recent case of nonlethal maternal CO poisoning with fetal death has come to the authors' attentions Acknowledgment The authors wish to thank Kevin Fallon, Ph.D., of Instrumentation Laboratory, Inc., for his technical advice regarding blood gas analysis of fetal blood.
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From page 248...
... A., "Should Hyperbaric Oxygen Be Used to Treat the Pregnant Patient for Acute Carbon Monoxide Poisoning? A Case Report and Literature Review,'' Journal of the American Medical Association, Vol.
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Key Terms

  • fetal death
  • fetal cohb
  • death due
  • medical examiner
  • chief medical

  • nonlethal maternal
  • cohb saturation
  • maternal carbon
  • maternal cohb
  • monoxide poisoning

  • carboxyhemoglobin concentration
  • american journal
  • maternal exposure
  • cohb levels
  • cohb concentrations

  • supplemental oxygen
  • pregnant patient
  • fetal carboxyhemoglobin
  • hyperbaric oxygen
  • fetal blood

  • monoxide intoxication
  • red discoloration
  • five times
  • fetal circulation
  • acute carbon

  • visceral organs
  • incomplete combustion
  • cohb concentration
  • heart dysfunction
  • suggested cohb


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